Provider Demographics
NPI:1790492635
Name:ALERACARE ARIZONA PHARMACY LLC
Entity Type:Organization
Organization Name:ALERACARE ARIZONA PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-716-2399
Mailing Address - Street 1:4045 E BELL RD STE 163
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2240
Mailing Address - Country:US
Mailing Address - Phone:602-971-6950
Mailing Address - Fax:602-404-2504
Practice Address - Street 1:4045 E BELL RD STE 163
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2240
Practice Address - Country:US
Practice Address - Phone:602-971-6950
Practice Address - Fax:602-404-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No251F00000XAgenciesHome Infusion
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy