Provider Demographics
NPI:1629484258
Name:RIGHTWAY PHARMACY LLC
Entity Type:Organization
Organization Name:RIGHTWAY PHARMACY LLC
Other - Org Name:RIGHTWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KANDARP
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-577-2020
Mailing Address - Street 1:10503 W THUNDERBIRD BLVD STE 101B
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2719
Mailing Address - Country:US
Mailing Address - Phone:623-266-0021
Mailing Address - Fax:623-266-0068
Practice Address - Street 1:14806 N DEL WEBB BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2146
Practice Address - Country:US
Practice Address - Phone:623-266-0021
Practice Address - Fax:623-266-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AZY0059903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ953300Medicaid
2146724OtherPK
2146724OtherPK