Healthcare Provider Details

I. General information

NPI: 1710430293
Provider Name (Legal Business Name): ANOIEL GEVERGIZIAN PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W CAMELBACK RD STE 290
PHOENIX AZ
85015
US

IV. Provider business mailing address

2001 W CAMELBACK RD STE 290
PHOENIX AZ
85015-3466
US

V. Phone/Fax

Practice location:
  • Phone: 844-866-3730
  • Fax:
Mailing address:
  • Phone: 844-866-3730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0016634
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302045832
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0005027
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17227
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number43970
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26139
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number020121
License Number StateKY
# 8
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021985
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: