Healthcare Provider Details

I. General information

NPI: 1235566720
Provider Name (Legal Business Name): DANHE CUI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORNER OF HIGHWAY 12&7 FORT DEFIANCE INDIAN HOSPITAL
FORT DEFIANCE AZ
86504
US

IV. Provider business mailing address

P.O. BOX 649 PHARMACY DEPARTMENT
FORT DEFIANCE AZ
86504
US

V. Phone/Fax

Practice location:
  • Phone: 928-729-8935
  • Fax:
Mailing address:
  • Phone: 928-729-8935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH05214
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: