Provider Demographics
NPI:1518406271
Name:BILLET PHARMACY INC
Entity Type:Organization
Organization Name:BILLET PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHADIMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-224-5538
Mailing Address - Street 1:6710 N 47TH AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-4121
Mailing Address - Country:US
Mailing Address - Phone:833-224-5538
Mailing Address - Fax:833-424-5538
Practice Address - Street 1:6718 W GREENWAY RD
Practice Address - Street 2:STE 202
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4583
Practice Address - Country:US
Practice Address - Phone:833-224-5538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
AZY0072413336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
8146760001OtherPTAN