STATE OF ARIZONA
1224 E Lowell St
Tucson, AZ 85721
520-621-6516
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | AZ | 000501 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 0322379 | OTHER |