Potters House Apothecary Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y005043 Issued in AZ

Legal business name

POTTERS HOUSE APOTHECARY INC

Practice address

21585 N 77TH Ave
Ste 1500
Peoria, AZ 85382

Phone

(623) 362-9322

Fax

(623) 362-9001

NPI assigned

Mar 18, 2009

Organization subpart

No

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

Authorized official

Name

Kevin Borg, PHARMD

Title

President/Pharmacist

Phone

(623) 362-9322

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Potter's House Apothecary Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kylie Fritze Harris

  • Compounded Sterile Preparations Pharmacist
  • Peoria, AZ
  • NPI 1487422127
  NPD (past)

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1922249127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21585 N 77TH AVE",
            "address_2": "STE 1500",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "623-362-9322",
            "fax_number": "623-362-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21585 N 77TH AVE",
            "address_2": "STE 1500",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "623-362-9322",
            "fax_number": "623-362-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTERS HOUSE APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "BORG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "623-362-9322",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y005043",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119474",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432524",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potter's House Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dorin T Popa, MD
• Catrina Popelier, MPH RN IBCLC
• Shawna Louise Porumb, RN
• Posh Dental Peoria PLLC
• Jodi L Poston
• Powell Chiropractic Health Center
• Jennifer Renee Powell, PHARM D
• Tyler Reed Powell, D.C.
• Power Back Batteries LLC
• Amber Powers

• Community/Retail Pharmacy in Peoria, AZ
• Providers in Peoria, 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 Mar 14, 2016; 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.