Healthcare Provider Details

I. General information

NPI: 1376914226
Provider Name (Legal Business Name): ROBERT PRINZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 S VAL VISTA DR
GILBERT AZ
85296-3140
US

IV. Provider business mailing address

714 S VAL VISTA DR
GILBERT AZ
85296-3140
US

V. Phone/Fax

Practice location:
  • Phone: 480-654-9337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberI011080
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: