Healthcare Provider Details

I. General information

NPI: 1952067225
Provider Name (Legal Business Name): ASHLEY DENAE POLETTI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W COMBS RD
SAN TAN VALLEY AZ
85140-9108
US

IV. Provider business mailing address

5807 E VISTA GRANDE
SAN TAN VALLEY AZ
85140-8300
US

V. Phone/Fax

Practice location:
  • Phone: 480-474-6601
  • Fax:
Mailing address:
  • Phone: 480-735-8960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS025331
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: