Healthcare Provider Details

I. General information

NPI: 1932025160
Provider Name (Legal Business Name): GHAZWAN REYAD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N ROOK AVE
TUCSON AZ
85711-1631
US

IV. Provider business mailing address

602 N ROOK AVE
TUCSON AZ
85711-1631
US

V. Phone/Fax

Practice location:
  • Phone: 520-305-8153
  • Fax: 520-305-8153
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number202621890
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: