Healthcare Provider Details

I. General information

NPI: 1881222859
Provider Name (Legal Business Name): SEAN BROOKS ROBERTS PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 S 83RD AVE STE A
PHOENIX AZ
85043-0905
US

IV. Provider business mailing address

7622 W ODEUM LN
PHOENIX AZ
85043-1239
US

V. Phone/Fax

Practice location:
  • Phone: 623-907-2472
  • Fax: 623-907-0548
Mailing address:
  • Phone: 623-694-7810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024444
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: