Healthcare Provider Details

I. General information

NPI: 1508740739
Provider Name (Legal Business Name): SHREENA GOVANI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3632 W PINNACLE PEAK RD STE 120-B
GLENDALE AZ
85310-4005
US

IV. Provider business mailing address

27018 N 64TH DR
PHOENIX AZ
85083-7416
US

V. Phone/Fax

Practice location:
  • Phone: 623-692-7033
  • Fax:
Mailing address:
  • Phone: 623-692-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024971
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberS024971
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: