Healthcare Provider Details

I. General information

NPI: 1871497206
Provider Name (Legal Business Name): CHETAN KHATRI R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 W FRYE RD STE 3
CHANDLER AZ
85224-6277
US

IV. Provider business mailing address

870 N BULLMOOSE DR
CHANDLER AZ
85224-3474
US

V. Phone/Fax

Practice location:
  • Phone: 480-855-7123
  • Fax: 480-855-7341
Mailing address:
  • Phone: 480-855-7123
  • Fax: 480-855-7341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS016503
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: