Provider Demographics
NPI:1083913370
Name:OLSON, CHARITY FELICIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:FELICIA
Last Name:OLSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 N ARIZONA BLVD
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85128-3214
Mailing Address - Country:US
Mailing Address - Phone:520-723-5552
Mailing Address - Fax:520-723-5551
Practice Address - Street 1:450 W ADAMSVILLE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-8582
Practice Address - Country:US
Practice Address - Phone:520-494-3223
Practice Address - Fax:520-494-3444
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist