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General NPI Number Information
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NPI Number | 1780241604
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Entity Type | Individual
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Provider Name | ALEXANDER SANIUK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2019
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Last Update Date | 05/27/2019
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Provider Practice Location Address
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Address Line | 500 N US HIGHWAY 89
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City | PRESCOTT
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State | AZ
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Zip | 86313-5001
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Country | US
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Telephone | 928-445-4860
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Fax |
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Provider Business Mailing Address
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Address Line | 5045 E VIA MONTOYA DR
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City | PHOENIX
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State | AZ
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Zip | 85054-7134
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Country | US
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Telephone | 847-858-1312
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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 | PHA.0022519
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S023638
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License Number State | AZ
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