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DEWEY PHARMACY
NPI 1902445802
Pharmacy - Community/Retail Pharmacy in Dewey, AZ

Active since December 26, 2019CLIA 03D2209288 · Waiver
12075 E STATE ROUTE 69, SUITE E, DEWEY, AZ 86327(928) 515-0455(928) 515-0456 Get Directions Write a Review

NPPES record last updated: December 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 8, 2020, Jan 10, 2020, Dec 26, 2019 (3 updates tracked since 2019).

About Dewey Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEWEY PHARMACY (NPI 1902445802) is a healthcare organization registered as a community/retail pharmacy in Dewey, Arizona and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through January 11, 2027, maintains a secondary practice location in Prescott Valley, and lists Jason James Dykstra, Manager, as its authorized official.

NPPES Registry Identity

NPI1902445802
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameNORTHERN ARIZONA PHARMACY LLC
Location Address12075 E STATE ROUTE 69, SUITE EDewey, AZ 86327
Mailing Address1932 N State Route 89Chino Valley, AZ 86323-5643 · (928) 515-0046 · Fax (928) 515-0047
Phone(928) 515-0455
Fax(928) 515-0456
Organization SubpartNo
Authorized OfficialJason James DykstraManager · (928) 515-0046
Enumeration DateDecember 26, 2019
Last NPPES UpdateDecember 8, 20203 updates tracked since enumeration
NPPES CertifiedDecember 8, 2020
✔ NPI 1902445802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
12075 E STATE ROUTE 69, Dewey, AZ 86327
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Other Names 1

Doing Business AsDewey Pharmacy

Secondary Practice Location 1

Location 112075 E State Route 89, Suite APrescott Valley, AZ 86314 · Phone (928) 515-0046 · Fax (928) 515-0047

Other Identifiers 1

Medicaid003672AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2209288

Northern Arizona Pharmacy · Dewey, AZ
Active · expires Jan 11, 2027
CLIA Number03D2209288
Laboratory TypePharmacy
Certificate Effective DateJanuary 12, 2025
Certificate Expiration DateJanuary 11, 2027
Laboratory DirectorJason J. Dykstra
Laboratory Phone(928) 515-0455
Laboratory LocationNorthern Arizona Pharmacy12075 E State Route 69 Ste E, Dewey, AZ 86327
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
228 services228 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
223 services223 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
13 services13 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
13 services13 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARY ELIZABETH MASSIEU DNP, FNP -C
Nurse Practitioner (Family)
12075 E STATE ROUTE 69
DEWEY, AZ 86327
Yavapai County (928) 777-9600
DANIELLE MARIE DURNAN FNP-C
Nurse Practitioner (Family)
12075 E STATE ROUTE 69
DEWEY, AZ 86327
Yavapai County (928) 772-1673

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northern Arizona Pharmacy LLC's NPI number?

The NPI number for Northern Arizona Pharmacy LLC is 1902445802. It was assigned to this organization in the NPPES registry on December 26, 2019. The provider is doing business as Dewey Pharmacy.

Where is Northern Arizona Pharmacy LLC located?

Northern Arizona Pharmacy LLC is located at 12075 E State Route 69 Suite E, Dewey, AZ 86327. The listed phone number is (928) 515-0455.

What is Northern Arizona Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Northern Arizona Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2209288) is associated with this NPI, valid through January 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northern Arizona Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 50 other insurers list Northern Arizona Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northern Arizona Pharmacy LLC was last updated on December 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.