Healthcare Provider Details

I. General information

NPI: 1407262553
Provider Name (Legal Business Name): SARKIS GEVORK PCHAKJIAN PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3132 E CAMELBACK RD
PHOENIX AZ
85016-4502
US

IV. Provider business mailing address

3132 E CAMELBACK RD
PHOENIX AZ
85016-4502
US

V. Phone/Fax

Practice location:
  • Phone: 602-955-6455
  • Fax:
Mailing address:
  • Phone: 602-955-6455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS017669
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: