Healthcare Provider Details

I. General information

NPI: 1629524780
Provider Name (Legal Business Name): LOUIS GRUBLER PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E HATCHER RD STE 1
PHOENIX AZ
85020-2699
US

IV. Provider business mailing address

850 E HATCHER RD STE 1
PHOENIX AZ
85020-2699
US

V. Phone/Fax

Practice location:
  • Phone: 602-216-1473
  • Fax:
Mailing address:
  • Phone: 602-216-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS01980
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: