Provider Demographics
NPI:1093554495
Name:LEMED SPECIALTY PHARMACY ARIZONA, LLC
Entity type:Organization
Organization Name:LEMED SPECIALTY PHARMACY ARIZONA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHALEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-913-4356
Mailing Address - Street 1:2417 3RD AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-6340
Mailing Address - Country:US
Mailing Address - Phone:347-913-4656
Mailing Address - Fax:718-231-2727
Practice Address - Street 1:2450 E GUADALUPE RD STE 110
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5116
Practice Address - Country:US
Practice Address - Phone:800-347-1137
Practice Address - Fax:718-231-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZY009814OtherARIZONA BOARD OF PHARMACY