Healthcare Provider Details

I. General information

NPI: 1407104110
Provider Name (Legal Business Name): CATHERINE PAGAYONAN ARAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11545 E APACHE TRAIL
APACHE JUNCTION AZ
85120
US

IV. Provider business mailing address

17500 N 67TH AVE APT 1112
GLENDALE AZ
85308
US

V. Phone/Fax

Practice location:
  • Phone: 480-986-1387
  • Fax:
Mailing address:
  • Phone: 480-254-6802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS019388
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: