Healthcare Provider Details

I. General information

NPI: 1003238544
Provider Name (Legal Business Name): ANTHONY BARBOSA PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 W BELL RD
PHOENIX AZ
85023-3418
US

IV. Provider business mailing address

1825 W BELL RD
PHOENIX AZ
85023-3418
US

V. Phone/Fax

Practice location:
  • Phone: 602-942-4764
  • Fax: 602-942-4839
Mailing address:
  • Phone: 602-942-4764
  • Fax: 602-942-4839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS016144
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: