Provider Demographics
NPI:1154092096
Name:ASSIBEY, WILLIAM BERKO JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BERKO
Last Name:ASSIBEY
Suffix:JR
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 1:2555 W FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4708
Mailing Address - Country:US
Mailing Address - Phone:562-676-7565
Mailing Address - Fax:
Practice Address - Street 1:2555 W FAIRVIEW ST STE 104
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4708
Practice Address - Country:US
Practice Address - Phone:480-705-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist