Healthcare Provider Details

I. General information

NPI: 1235814955
Provider Name (Legal Business Name): JOSEPH ENDLER RPH, BGCP.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 N CENTRAL AVE STE 829
PHOENIX AZ
85004-1021
US

IV. Provider business mailing address

2828 N CENTRAL AVE STE 829
PHOENIX AZ
85004-1021
US

V. Phone/Fax

Practice location:
  • Phone: 602-412-1040
  • Fax:
Mailing address:
  • Phone: 602-412-1040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS011567
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberS011567
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: