Active NPI
Northern Arizona Pharmacy
Doing business as Dewey Pharmacy
- Long Term Care Pharmacy
- Dewey, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- NORTHERN ARIZONA PHARMACY
- Doing business as
- Dewey Pharmacy
- Practice address
- 12075 E State Route 69 Ste E
Dewey, AZ 86327-4569 - Phone
- (928) 515-0455
- Fax
- (928) 515-0456
- NPI assigned
- Jun 18, 2022
- Last updated
- Jun 18, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jason James Dykstra, PHARMD
- Title
- Manager
- Phone
- (928) 515-0046
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | NU | Primary |
Addresses
Primary practice location
12075 E State Route 69 Ste E
Dewey, AZ 86327-4569
Mailing address
1932 N State Route 89
Chino Valley, AZ 86323-5643
Phone (928) 515-0046
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003672 | Medicaid | AZ |
Other names 1
- Dewey Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Dewey Pharmacy
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Cordes Pharmacy
- Community/Retail Pharmacy
- Cordes Lakes, AZ
- NPI 1669060166
Locations
12075 E State Route 69
Ste E
Dewey, AZ 86327
Phone (928) 515-0455
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Chino Valley, AZ
- NPI 1801126024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655510400000",
"number": "1932830205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1932 N STATE ROUTE 89",
"city": "CHINO VALLEY",
"state": "AZ",
"postal_code": "863235643",
"telephone_number": "928-515-0046",
"fax_number": "928-515-0047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12075 E STATE ROUTE 69 STE E",
"city": "DEWEY",
"state": "AZ",
"postal_code": "863274569",
"telephone_number": "928-515-0455",
"fax_number": "928-515-0456"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN ARIZONA PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-18",
"last_updated": "2022-06-18",
"certification_date": "2022-06-18",
"status": "A",
"authorized_official_last_name": "DYKSTRA",
"authorized_official_first_name": "JASON",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "928-515-0046",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003672",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Dewey Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dewey, AZ
- Monreal Family Services, LLC
- Monreal Family Services, LLC
- Toni L Monreal, LCSW
- Keri Newberry
- Cindy Kay Noble
- Northern Arizona Pharmacy LLC (Dewey Pharmacy)
- Candace Oen, P. A. -C.
- Frederic Leland Ondovchak, R.N., M.S.N., A.P.R.
- Angela Payne, LPN
- Prescott Renal Care Group, LLC (Renal Care Group Prescott)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.