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General NPI Number Information
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NPI Number | 1962799577
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Entity Type | Individual
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Provider Name | ELESA KANTZOS RPH
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Gender | Female
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Dates
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Enumeration Date | 07/03/2011
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 3931 S GILBERT RD
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City | GILBERT
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State | AZ
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Zip | 85297-2004
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Country | US
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Telephone | 480-281-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 7001 N SCOTTSDALE RD 1010
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City | SCOTTSDALE
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State | AZ
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Zip | 85253-3658
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Country | US
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Telephone | 330-268-6590
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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 | S015846
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License Number State | AZ
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