Healthcare Provider Details

I. General information

NPI: 1285945782
Provider Name (Legal Business Name): ALAN BRADLEY HOTZ R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 24TH ST
YUMA AZ
85364-6430
US

IV. Provider business mailing address

500 W 24TH ST
YUMA AZ
85364-6430
US

V. Phone/Fax

Practice location:
  • Phone: 928-782-2529
  • Fax: 928-343-9219
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS007289
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: