Provider Demographics
NPI:1437327244
Name:CARESITE PHARMACY OF ARIZONA LLC
Entity Type:Organization
Organization Name:CARESITE PHARMACY OF ARIZONA LLC
Other - Org Name:CARESITE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:MESSINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-7285
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:MC 24-15
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-271-7965
Mailing Address - Fax:
Practice Address - Street 1:3805 EAST BELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:570-271-7965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUREHEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy