Provider Demographics
NPI:1407284458
Name:HSP INC
Entity Type:Organization
Organization Name:HSP INC
Other - Org Name:SCOTTSDALE HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED ESLAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMISSIREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-444-6612
Mailing Address - Street 1:3501 N SCOTTSDALE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5649
Mailing Address - Country:US
Mailing Address - Phone:480-290-7051
Mailing Address - Fax:480-290-7051
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5649
Practice Address - Country:US
Practice Address - Phone:480-290-7051
Practice Address - Fax:480-290-7051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY005765333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142553OtherPK