Healthcare Provider Details

I. General information

NPI: 1982929451
Provider Name (Legal Business Name): MARLA JEANNE TREPANIER RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NACO RD
BISBEE AZ
85603-9655
US

IV. Provider business mailing address

1428 N POMERENE RD
BENSON AZ
85602-7908
US

V. Phone/Fax

Practice location:
  • Phone: 520-432-2274
  • Fax:
Mailing address:
  • Phone: 520-349-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS010726
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: