OLD PUEBLO DRUG

Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

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Contact Information

OLD PUEBLO DRUG

3272 HWY 82
SONOITA, AZ 85637

Phone: 520-455-0058
Fax: 502-455-4782
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Community/Retail Pharmacy	3336C0003X	58	Medical Supply Company with Pharmacist
Pharmacy	333600000X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for OLD PUEBLO DRUG

NPI Number 1093859795

LBN Legal business name OLD PUEBLO DRUG

Authorized official MYRON GINSBURG - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/16/2007

Last updated 06/05/2015 - About 11 years ago

Identifiers

AZ	License #	YO2983
AZ	Medicaid	307787
	Other	1997300	PK

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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