Healthcare Provider Details

I. General information

NPI: 1184778664
Provider Name (Legal Business Name): WAYNE FREDERICK OBERFIELD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9185 E PIMA CENTER PKWY STE 200
SCOTTSDALE AZ
85258-4646
US

IV. Provider business mailing address

PO BOX 25991
SCOTTSDALE AZ
85255-0116
US

V. Phone/Fax

Practice location:
  • Phone: 855-847-3553
  • Fax: 855-847-3558
Mailing address:
  • Phone: 480-201-1275
  • Fax: 413-622-0654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36033
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS 27719
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10090
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: