Healthcare Provider Details

I. General information

NPI: 1114479565
Provider Name (Legal Business Name): WILLIAM ASSALY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W THOMAS RD STE 190
PHOENIX AZ
85013-4237
US

IV. Provider business mailing address

7464 E PLEASANT RUN
SCOTTSDALE AZ
85258-3122
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3970
  • Fax:
Mailing address:
  • Phone: 480-326-7815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12872
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: