Healthcare Provider Details

I. General information

NPI: 1881105443
Provider Name (Legal Business Name): GHAZALEH KHADEMI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 E VIA LINDA
SCOTTSDALE AZ
85258-5404
US

IV. Provider business mailing address

8900 E VIA LINDA
SCOTTSDALE AZ
85258-5404
US

V. Phone/Fax

Practice location:
  • Phone: 480-657-6433
  • Fax:
Mailing address:
  • Phone: 480-295-1042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS022766
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: