Healthcare Provider Details

I. General information

NPI: 1801551627
Provider Name (Legal Business Name): RAYNA FLYNN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 W BELL RD
GLENDALE AZ
85308-3530
US

IV. Provider business mailing address

17369 W RED BIRD RD
SURPRISE AZ
85387-1024
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS025506
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: