Provider Demographics
NPI:1306475678
Name:METIER PHARMACY LLC
Entity type:Organization
Organization Name:METIER PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RANDLE
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-796-1178
Mailing Address - Street 1:4214 E INDIAN SCHOOL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5339
Mailing Address - Country:US
Mailing Address - Phone:602-775-5699
Mailing Address - Fax:
Practice Address - Street 1:3511 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5114
Practice Address - Country:US
Practice Address - Phone:602-835-2675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METIER HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-07
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty