Provider Demographics
NPI:1760686653
Name:CATHOLIC HEALTHCARE WEST
Entity Type:Organization
Organization Name:CATHOLIC HEALTHCARE WEST
Other - Org Name:CRS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-406-6001
Mailing Address - Street 1:222 W THOMAS RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4419
Mailing Address - Country:US
Mailing Address - Phone:602-406-3970
Mailing Address - Fax:602-406-7145
Practice Address - Street 1:222 W THOMAS RD
Practice Address - Street 2:SUITE 108
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4419
Practice Address - Country:US
Practice Address - Phone:602-406-3970
Practice Address - Fax:602-406-7145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3471183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3471OtherSTATE LICENCE NO.
AZBC7786164OtherDEA NUMBER