Provider Demographics
NPI:1306106984
Name:LONG TERM STRATEGIES
Entity type:Organization
Organization Name:LONG TERM STRATEGIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-951-4913
Mailing Address - Street 1:107 W WADE LN
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-4872
Mailing Address - Country:US
Mailing Address - Phone:928-468-8299
Mailing Address - Fax:928-474-7439
Practice Address - Street 1:107 W WADE LN STE 4
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-4872
Practice Address - Country:US
Practice Address - Phone:928-468-8299
Practice Address - Fax:928-474-7439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X
AZY0054803336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0357536OtherNCPDP PROVIDER IDENTIFICATION NUMBER