AVELLA OF CHANDLER, INC
2155 E Conference Dr Ste 101
Tempe, AZ 85284
480-775-4784
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336C0004X | Suppliers - Pharmacy - Compounding Pharmacy | AZ | Y005093 |
N | 3336S0011X | Suppliers - Pharmacy | AZ | Y005093 |
Y | 3336C0003X | Suppliers - Pharmacy | AZ | Y005093 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
566515 | AZ | MEDICAID | |
NCPDP | 0324157 | OTHER |