MEDICARE: RAND ADEL SALEEM GHAREEB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	S025958	AZ

General Provider Information

NPI Number	:	1790495216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAND ADEL SALEEM GHAREEB

Provider Business Mailing Address
First Line	:	5895 W PEORIA AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-1303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5895 W PEORIA AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-1303
Country	:	US
Telephone Number	:	623-934-9152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	01/04/2025

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