Healthcare Provider Details

I. General information

NPI: 1396286043
Provider Name (Legal Business Name): SMITA DHURI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 E PECOS RD
CHANDLER AZ
85225-2461
US

IV. Provider business mailing address

4800 S ALMA SCHOOL RD APT 2083
CHANDLER AZ
85248-5564
US

V. Phone/Fax

Practice location:
  • Phone: 480-857-2508
  • Fax:
Mailing address:
  • Phone: 860-965-0669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS022382
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: