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General NPI Number Information
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NPI Number | 1124518733
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Entity Type | Individual
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Provider Name | OSAMAH ELJERDI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 220 W 6TH ST
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City | TUCSON
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State | AZ
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Zip | 85721-0300
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Country | US
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Telephone | 520-626-1793
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 N 44TH ST APT 2128
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City | PHOENIX
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State | AZ
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Zip | 85008-5727
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Country | US
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Telephone | 520-247-3997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S022673
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License Number State | AZ
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