Healthcare Provider Details
I. General information
NPI: 1063406361
Provider Name (Legal Business Name): ANNA ELIZABETH PERRIN PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/01/2005
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 E AJO WAY
TUCSON AZ
85713-6204
US
IV. Provider business mailing address
16688 S SAGUARO VIEW LN # 331
VAIL AZ
85641-6551
US
V. Phone/Fax
- Phone: 520-874-4903
- Fax:
- Phone: 520-425-2092
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 016532 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | S016000 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: