Individual
DR. GAVRILO DURICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
900 W DEUCE OF CLUBS, SHOW LOW, AZ 85901-6214
(928) 532-5660
Mailing address
2700 S WHT MTN RD APT 622, SHOW LOW, AZ 85901-7334
(716) 951-9508
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019569
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3191
AZ IMMUNIZATION CERTIFICATE
AZ
01
—
S019569
AZ PHARMACIST LICENSE
AZ
Enumeration date
11/20/2012
Last updated
11/20/2012
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