Organization Active NPI

Healthcare Pharmacy LLC

  • Specialty Pharmacy
  • Phoenix, AZ
National Provider Identifier
1710674668
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
HEALTHCARE PHARMACY LLC
Practice address
2320 W Peoria Ave Ste D132-a
Phoenix, AZ 85029-4753
Phone
(602) 704-0044
Fax
(602) 767-5522
NPI assigned
Apr 20, 2023
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ron Gresham
Title
President
Phone
(602) 704-0044

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Mail Order Pharmacy 3336M0002X NU
Specialty Pharmacy 3336S0011X NU Primary

Addresses

Primary practice location

2320 W Peoria Ave Ste D132-a
Phoenix, AZ 85029-4753

Mailing address

2320 W Peoria Ave Ste D132-a
Phoenix, AZ 85029-4753
Phone (602) 704-0044

Other identifiers 1

IdentifierTypeStateIssuer
155435MedicaidAZ

National Provider Directory

National Provider Directory

Locations

2320 W Peoria Ave
Ste D132A
Phoenix, AZ 85029
Phone (602) 704-0044

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1710674668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 W PEORIA AVE STE D132-A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294753",
            "telephone_number": "602-704-0044",
            "fax_number": "602-767-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 W PEORIA AVE STE D132-A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294753",
            "telephone_number": "602-704-0044",
            "fax_number": "602-767-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-704-0044"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155435",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.