Individual
THI NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
17550 N 79TH AVE, GLENDALE, AZ 85308-8711
(623) 776-4003
Mailing address
3213 N 109TH AVE, AVONDALE, AZ 85392-4044
(602) 295-8705
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
S022642
AZ
Other
Enumeration date
09/25/2017
Last updated
01/18/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us