Provider Demographics
NPI:1245780444
Name:TAZI, ANU (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANU
Middle Name:
Last Name:TAZI
Suffix:
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 1:7810 N 14TH PL APT 1009
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4310
Mailing Address - Country:US
Mailing Address - Phone:602-237-8681
Mailing Address - Fax:
Practice Address - Street 1:5050 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-7324
Practice Address - Country:US
Practice Address - Phone:602-237-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRPHS021654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist