Trillium Specialty Hospital East Valley

LBN: Fuller Selle Llc
Trillium Specialty Hospital East Valley is an health care organization with primary practice located at 215 S Power Rd , Mesa AZ 85206-5235. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Compounding Pharmacy, Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Fuller Selle Llc can be contacted via phone (408) 985-6992, or through Alexander, Gary via phone (210) 745-4000.

Contact Information

Primary practice address
215 S Power Rd Mesa AZ 85206-5235
Phone: (408) 985-6992
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Alexander, Gary
Phone: (210) 745-4000

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Institutional Pharmacy 3336I0012X
Suppliers / Long Term Care Pharmacy 3336L0003X Y004869 Arizona

Profile Details

NPI number 1053573154
LBN Legal business name Fuller Selle Llc
DBA Doing business as Trillium Specialty Hospital East Valley
Authorized official Alexander, Gary
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2008
Last updated Jun 30th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053573154 NPPES
Other 0355392 OTHER ID NUMBER

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