Avella of Chandler, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y005093 Issued in AZ

Legal business name

AVELLA OF CHANDLER, INC

Practice address

2155 E Conference Dr
Ste 101
Tempe, AZ 85284-2604

Phone

(480) 775-4784

Fax

(480) 730-9734

NPI assigned

Jun 17, 2005

Organization subpart

Yes

Parent organization

APOTHECARY HOLDINGS INCAs reported in NPPES

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

Authorized official

Name

John D Musil, PHARMD

Title

Ceo

Phone

(623) 434-3657

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1720083462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 W WHISPERING WIND DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850850678",
            "telephone_number": "623-434-1700",
            "fax_number": "623-434-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E CONFERENCE DR",
            "address_2": "STE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842604",
            "telephone_number": "480-775-4784",
            "fax_number": "480-730-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVELLA OF CHANDLER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APOTHECARY HOLDINGS INC",
        "enumeration_date": "2005-06-17",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "MUSIL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-434-3657",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y005093",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AZ",
            "license": "Y005093",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "AZ",
            "license": "Y005093",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "566515",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0324157",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.