Provider Demographics
NPI:1235464397
Name:LATIMER, LAURA R (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:LATIMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:R
Other - Last Name:KESLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:500 S 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-9700
Mailing Address - Country:US
Mailing Address - Phone:623-907-4938
Mailing Address - Fax:480-988-6303
Practice Address - Street 1:3261 E PECOS RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1200
Practice Address - Country:US
Practice Address - Phone:480-988-6301
Practice Address - Fax:480-988-6303
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist