Healthcare Provider Details

I. General information

NPI: 1689288037
Provider Name (Legal Business Name): AKEEL DAHER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/03/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28635 N N VLY PKWY
PHOENIX AZ
85085-5434
US

IV. Provider business mailing address

9820 N 49TH AVE
GLENDALE AZ
85302-2411
US

V. Phone/Fax

Practice location:
  • Phone: 623-582-9207
  • Fax:
Mailing address:
  • Phone: 602-810-9784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024264
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: