Healthcare Provider Details

I. General information

NPI: 1184388548
Provider Name (Legal Business Name): AMANDA URBAN-TOVAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2021
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 E 22ND ST
TUCSON AZ
85710-5126
US

IV. Provider business mailing address

10145 E PLEASANT VIEW WAY
TUCSON AZ
85748-7628
US

V. Phone/Fax

Practice location:
  • Phone: 520-790-9492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS025518
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: