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General NPI Number Information
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NPI Number | 1528464641
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Entity Type | Individual
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Provider Name | JOHANNA LIZETTE LOPEZ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 500 S 99TH AVE
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City | TOLLESON
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State | AZ
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Zip | 85353-9700
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Country | US
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Telephone | 623-235-2360
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Fax | 623-235-2361
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Provider Business Mailing Address
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Address Line | 10675 W INDIAN SCHOOL RD
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City | AVONDALE
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State | AZ
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Zip | 85392-5645
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Country | US
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Telephone | 623-772-0502
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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 | S021007
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | S021007
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License Number State | AZ
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