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General NPI Number Information
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NPI Number | 1528694841
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Entity Type | Individual
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Provider Name | GAVIN CHRISTOPHER CHILES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 650 E INDIAN SCHOOL RD
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City | PHOENIX
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State | AZ
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Zip | 85012-1839
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Country | US
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Telephone | 602-277-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 2940 N 40TH ST APT 27
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City | PHOENIX
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State | AZ
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Zip | 85018-7158
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Country | US
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Telephone | 757-620-0163
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | S024134
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License Number State | AZ
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