Healthcare Provider Details

I. General information

NPI: 1689949174
Provider Name (Legal Business Name): GINA C GUZZETTA PHARM.D., RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E BEARDSLEY RD
PHOENIX AZ
85050-1300
US

IV. Provider business mailing address

2450 E BEARDSLEY RD
PHOENIX AZ
85050-1300
US

V. Phone/Fax

Practice location:
  • Phone: 480-375-2878
  • Fax: 480-375-2875
Mailing address:
  • Phone: 480-375-2878
  • Fax: 480-375-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16793
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: