Provider Demographics
NPI:1083081509
Name:GERMAN DOBSON CVS LLC
Entity Type:Organization
Organization Name:GERMAN DOBSON CVS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-532-3200
Mailing Address - Street 1:60 E DEUCE OF CLUBS
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-4814
Mailing Address - Country:US
Mailing Address - Phone:928-530-3200
Mailing Address - Fax:
Practice Address - Street 1:60 E DEUCE OF CLUBS
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-4814
Practice Address - Country:US
Practice Address - Phone:928-530-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty