Healthcare Provider Details

I. General information

NPI: 1679949788
Provider Name (Legal Business Name): ANYA HOAGLAND PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9152 E BROWN RD
MESA AZ
85207-4339
US

IV. Provider business mailing address

9152 E BROWN RD
MESA AZ
85207-4339
US

V. Phone/Fax

Practice location:
  • Phone: 480-357-4833
  • Fax:
Mailing address:
  • Phone: 480-357-4833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021476
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: