| Organization Name: | WICKENBURG HOSPITAL PHARMACY |
| NPI Number: | 1417359753 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROGER ROSE (PHARMACY DIRECTOR) |
| Mailing Address: | 520 Rose Ln Wickenburg |
| State: | AZ US |
| Postal Code: | 853901447 |
| Phone Number: | 9286844980 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2014 |
| NPI Last Update Date: | 09/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NR1301X |
| License Number: | BW8158570 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Rural |
| Taxonomy Definition: | |