Provider Demographics
NPI:1003298910
Name:OUR PHARMACY
Entity Type:Organization
Organization Name:OUR PHARMACY
Other - Org Name:SNS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGHRAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:480-812-3725
Mailing Address - Street 1:2080 N DOBSON RD
Mailing Address - Street 2:#3
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224
Mailing Address - Country:US
Mailing Address - Phone:480-812-3725
Mailing Address - Fax:480-726-7340
Practice Address - Street 1:2080 N DOBSON RD
Practice Address - Street 2:#3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-812-3725
Practice Address - Fax:480-726-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-27
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY006811333600000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy