Canyonlands Community Health Care

Organization Active NPI Community/Retail Pharmacy · Page, AZ

NPI 1689021933 · NPPES record last updated Sep 23, 2021

Key facts

NPI
1689021933
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
Y006821 (AZ)
Legal business name
CANYONLANDS COMMUNITY HEALTH CARE
Practice address
467 Vista Avenue
Page, AZ 86040
Phone
(928) 645-6620
Fax
(928) 645-6621
NPI assigned
May 17, 2016
Organization subpart
No

Authorized official

Name
Andrew Lewandowski, PHARMD
Title
Director of Pharmacy, Pic, Ao
Phone
(928) 645-6620

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lake Powell Medical Center (15 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y006821 AZ Yes

Addresses

Primary practice location

467 Vista Avenue
Page, AZ 86040

Mailing address

PO Box 1625
Page, AZ 86040-1625
Phone (928) 645-6620

Other identifiers

IdentifierTypeStateIssuer
2160535OtherPK
174027MedicaidAZ
1689021933MedicaidUT

Other names

  • Canyonlands Community Healthcare Doing business as

Other providers in Page, AZ

All providers in Page, AZ · Community/Retail Pharmacy in Arizona

Sources for this page

Verify at the official NPI Registry.