Provider Demographics
NPI:1033510052
Name:GOOD, CYNTHIA ANNE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:GOOD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8224 N 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5571
Mailing Address - Country:US
Mailing Address - Phone:602-576-6012
Mailing Address - Fax:
Practice Address - Street 1:8224 N 13TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5571
Practice Address - Country:US
Practice Address - Phone:602-576-6012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist