Provider Demographics
NPI:1093608846
Name:PEGASUS SUPPLY CHAIN
Entity type:Organization
Organization Name:PEGASUS SUPPLY CHAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-556-8039
Mailing Address - Street 1:2717 W SABLE AVE
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-0035
Mailing Address - Country:US
Mailing Address - Phone:314-556-8039
Mailing Address - Fax:
Practice Address - Street 1:2717 W SABLE AVE
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-0035
Practice Address - Country:US
Practice Address - Phone:314-556-8039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty