Provider Demographics
NPI:1174286595
Name:REHOVSKY, JAMES ROLAND (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROLAND
Last Name:REHOVSKY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18919 W VERDE LN
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-8587
Mailing Address - Country:US
Mailing Address - Phone:602-350-6171
Mailing Address - Fax:
Practice Address - Street 1:18919 W VERDE LN
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-8587
Practice Address - Country:US
Practice Address - Phone:602-350-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS8636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist