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Individual

FARIBORZ BOROUMAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7975 W PEORIA AVE, PEORIA, AZ 85345-5941
(623) 878-4307
Mailing address
7427 W SANNA ST, PEORIA, AZ 85345-7195
(520) 744-3531

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S013652
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S013652
ARIZONA STATE BOARD PHARMACY
AZ
Enumeration date
01/23/2014
Last updated
01/23/2014
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