Provider Demographics
NPI:1083027775
Name:AKHLAGHI, AMIR (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:AKHLAGHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 E ANGELA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2394
Mailing Address - Country:US
Mailing Address - Phone:480-221-2501
Mailing Address - Fax:
Practice Address - Street 1:4519 E ANGELA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2394
Practice Address - Country:US
Practice Address - Phone:480-221-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS13066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist