Healthcare Provider Details

I. General information

NPI: 1629397583
Provider Name (Legal Business Name): SCOTT ANTHONY EFFINGER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 N. 51ST AVENUE SUITE 203
PHOENIX AZ
85031
US

IV. Provider business mailing address

2702 N. 3RD STREET SUITE 4020
PHOENIX AZ
85004
US

V. Phone/Fax

Practice location:
  • Phone: 623-247-6266
  • Fax: 623-247-9742
Mailing address:
  • Phone: 602-323-3396
  • Fax: 602-323-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS012451
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: