Provider Demographics
NPI:1225470420
Name:KHOURY, SAWSAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SAWSAN
Middle Name:
Last Name:KHOURY
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 1:34399 N CAVE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-5134
Mailing Address - Country:US
Mailing Address - Phone:480-296-7410
Mailing Address - Fax:480-595-9032
Practice Address - Street 1:34399 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-5134
Practice Address - Country:US
Practice Address - Phone:480-296-7410
Practice Address - Fax:480-595-9032
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist