Healthcare Provider Details

I. General information

NPI: 1225311251
Provider Name (Legal Business Name): ANDREW STEVEN DEMOTTO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10005 E OSBORN RD
SCOTTSDALE AZ
85256-4019
US

IV. Provider business mailing address

10005 E OSBORN RD
SCOTTSDALE AZ
85256-4019
US

V. Phone/Fax

Practice location:
  • Phone: 480-946-9227
  • Fax:
Mailing address:
  • Phone: 480-362-7400
  • Fax: 480-362-5950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0007731
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: