<Unavail>

LBN: Raley'S Arizona Llc
<Unavail> is an health care organization with primary practice located at 23760 S Power Rd , Queen Creek AZ 85142-6151. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Raley'S Arizona Llc can be contacted via phone (480) 279-5701, or through Mckinley, Mike via phone (480) 895-5372.

Contact Information

Primary practice address
23760 S Power Rd Queen Creek AZ 85142-6151
Phone: (480) 279-5701
Fax: (480) 279-5703
Website:
Map and Directions
Authorized official contact:
Name: Mckinley, Mike
Phone: (480) 895-5372

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X Y004026 Arizona
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1811085681
LBN Legal business name Raley'S Arizona Llc
DBA Doing business as <Unavail>
Authorized official Mckinley, Mike
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2006
Last updated Apr 20th, 2022 - about 4 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 1811085681 NPPES
Arizona MEDICAID 887622
Arizona Other 0352308

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