Provider Demographics
NPI:1801193503
Name:A2Z PHARMACY LLC
Entity Type:Organization
Organization Name:A2Z PHARMACY LLC
Other - Org Name:A2Z HEALTHMART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJNI
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-422-0062
Mailing Address - Street 1:1408 ARCHDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-4421
Mailing Address - Country:US
Mailing Address - Phone:980-355-0906
Mailing Address - Fax:704-705-1236
Practice Address - Street 1:1408 ARCHDALE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-4421
Practice Address - Country:US
Practice Address - Phone:980-355-0906
Practice Address - Fax:704-705-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336M0003X
NC109273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3458468OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NC0602645Medicaid
3458468OtherNCPDP PROVIDER IDENTIFICATION NUMBER