Provider Demographics
NPI:1609251537
Name:ALLERGYRX
Entity Type:Organization
Organization Name:ALLERGYRX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:480-299-5595
Mailing Address - Street 1:3960 E PALM ST BLDG 5
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1118
Mailing Address - Country:US
Mailing Address - Phone:480-339-2382
Mailing Address - Fax:480-820-1833
Practice Address - Street 1:3960 E PALM ST BLDG 5
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-1118
Practice Address - Country:US
Practice Address - Phone:480-339-2382
Practice Address - Fax:480-820-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY0064143336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy