Provider Demographics
NPI:1730269895
Name:CARESITE PHARMACY OF ARIZONA LLC
Entity type:Organization
Organization Name:CARESITE PHARMACY OF ARIZONA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:MESSINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-7285
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:MC 24-15
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-2415
Mailing Address - Country:US
Mailing Address - Phone:570-271-7965
Mailing Address - Fax:570-271-7370
Practice Address - Street 1:18700 N 64TH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7109
Practice Address - Country:US
Practice Address - Phone:623-362-3999
Practice Address - Fax:623-352-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy