Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fuller Selle LLC

Organization Compounding Pharmacy · NPI 1053573154

Fuller Selle LLC is a Compounding Pharmacy in Mesa, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

215 S Power Rd
Mesa, AZ 85206-5235
Phone: (408) 985-6992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Long Term Care Pharmacy (primary) Taxonomy 3336L0003X · Licence Y004869 (AZ)
Compounding Pharmacy Taxonomy 3336C0004X
Institutional Pharmacy Taxonomy 3336I0012X

Record details

NPI number1053573154
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Alexander — Cfo · (210) 745-4000
Other names Trillium Specialty Hospital East Valley
NPI enumeratedJune 30, 2008
Last updated in NPPESJune 30, 2008
Mailing address777 E Sonterra Blvd, Ste 300, San Antonio, TX 78258-4246

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