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NPI Code Detail

MEDICARE: GHAZALEH KHADEMI RPH

MEDICARE:   GHAZALEH  KHADEMI  RPH
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
1183500000XPharmacistS022766AZ

General Provider Information

NPI Number : 1881105443
Entity Type Code : Individual
Provider Name (Legal Business Name) : GHAZALEH KHADEMI RPH
Provider Business Mailing Address
First Line : 9526 N 132ND PL
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-6324
Country : US
Telephone Number : 480-295-1042
Fax Number :
Provider Business Practice Location Address
First Line : 10660 GRAND AVE
Second Line :
City : SUN CITY
State : AZ
Zip : 85351-3433
Country : US
Telephone Number : 623-876-8220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2017
Last Update Date : 10/22/2017

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Directions to “ GHAZALEH KHADEMI RPH” Practice Location

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