Provider Demographics
NPI:1437571551
Name:TOPICAL SOLUTIONS PHARMACY
Entity Type:Organization
Organization Name:TOPICAL SOLUTIONS PHARMACY
Other - Org Name:TOPICAL SOLUTIONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER 100
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BOLES
Authorized Official - Suffix:III
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:480-201-0481
Mailing Address - Street 1:20622 N CAVE CREEK RD STE C-121
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4452
Mailing Address - Country:US
Mailing Address - Phone:480-351-8278
Mailing Address - Fax:480-351-8277
Practice Address - Street 1:20622 N CAVE CREEK RD STE C-121
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024
Practice Address - Country:US
Practice Address - Phone:480-351-8278
Practice Address - Fax:480-351-8277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY005816333600000X, 3336C0003X, 3336C0004X, 3336S0011X, 3336C0004X, 3336S0011X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ890764Medicaid
2143770OtherPK