Komatke Pharmacy

LBN: Gila River Health Care Corporation
Komatke Pharmacy is an health care organization with primary practice located at 17487 S Healthcare Dr , Laveen AZ 85339-8500. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, Suppliers / Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty. Gila River Health Care Corporation can be contacted via phone (520) 550-6022, or through Croll, Larry via phone (602) 528-1200.

Contact Information

Primary practice address
17487 S Healthcare Dr Laveen AZ 85339-8500
Phone: (520) 550-6022
Fax: (520) 550-6028
Website:
Map and Directions
Authorized official contact:
Name: Croll, Larry PHARMD
Phone: (602) 528-1200

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Suppliers / Pharmacy 333600000X

Profile Details

NPI number 1144359852
LBN Legal business name Gila River Health Care Corporation
DBA Doing business as Komatke Pharmacy
Authorized official Croll, Larry PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Mar 6th, 2007
Last updated Apr 28th, 2017 - about 9 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 1144359852 NPPES
Other 1991256 PK
MEDICAID AHCCCS334582 PK

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