Healthcare Provider Details

I. General information

NPI: 1659748234
Provider Name (Legal Business Name): KELSI LEIGH GIACALONE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSI LEIGH LISH

II. Dates (important events)

Enumeration Date: 08/30/2015
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19003 N R H JOHNSON BLVD
SUN CITY WEST AZ
85375-4402
US

IV. Provider business mailing address

19003 N R H JOHNSON BLVD
SUN CITY WEST AZ
85375-4402
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-3002
  • Fax: 623-584-2756
Mailing address:
  • Phone: 623-584-3002
  • Fax: 623-584-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.298922
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: