Provider Demographics
NPI:1003404278
Name:COSTANOA HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:COSTANOA HEALTH SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STIGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-588-0387
Mailing Address - Street 1:14500 N NORTHSIGHT BLVD STE 314
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3663
Mailing Address - Country:US
Mailing Address - Phone:855-588-0387
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD STE 340
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2432
Practice Address - Country:US
Practice Address - Phone:855-977-0975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHIL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-04
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy