| Organization Name: | CASA GRANDE PHARMACY INC |
| NPI Number: | 1386017564 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOHAMED ESLAM ELMISSIREY (OFFICER,PIC,AO) |
| Mailing Address: | 1659 E Florence Blvd Ste 7 Casa Grande |
| State: | AZ US |
| Postal Code: | 851224785 |
| Phone Number: | 5205185720 |
| Fax Number: | 4803712757 |
| NPI Enumeration Date: | 11/10/2015 |
| NPI Last Update Date: | 02/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |