Provider Demographics
NPI:1316183619
Name:POLYCLINIC PHARMACY INC.
Entity Type:Organization
Organization Name:POLYCLINIC PHARMACY INC.
Other - Org Name:A2Z DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:INDERJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:RAKALLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:602-218-5223
Mailing Address - Street 1:9299 W OLIVE AVE
Mailing Address - Street 2:STE 306
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345
Mailing Address - Country:US
Mailing Address - Phone:602-218-5223
Mailing Address - Fax:888-341-9623
Practice Address - Street 1:9299 W OLIVE AVE
Practice Address - Street 2:STE 306
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345
Practice Address - Country:US
Practice Address - Phone:602-218-5223
Practice Address - Fax:888-341-9623
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POLYCLINIC PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-17
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies