State of Arizona

NPI #1538170162 in Phoenix, Arizona

Provider Information

NPI Number
1538170162
Entity Type
Organization
Organization Name
State of Arizona
Primary Specialty
Pharmacy - Institutional Pharmacy
Enumeration Date
Aug 10, 2006
Last Updated
Jul 19, 2018

Practice Location

Address
2500 E VAN BUREN ST
State
Arizona
ZIP Code
85008-6037
Phone
(602) 220-6060

Authorized Official

Name
KELLY HOLLADAY, PHARMD
Title
DOP
Phone
(602) 220-6060

Specialties & Taxonomy Codes

Specialty
Pharmacy
Pharmacy - Institutional PharmacyInstitutional Pharmacy

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