Provider Demographics
NPI:1275311334
Name:SOLIMAN, GEORGETTE SAMI
Entity Type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:SAMI
Last Name:SOLIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15693 W JENAN DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-1035
Mailing Address - Country:US
Mailing Address - Phone:623-694-4521
Mailing Address - Fax:
Practice Address - Street 1:13723 N LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-4268
Practice Address - Country:US
Practice Address - Phone:623-255-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist