Provider Demographics
NPI:1316589807
Name:LUCA, XHOVANA
Entity Type:Individual
Prefix:
First Name:XHOVANA
Middle Name:
Last Name:LUCA
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 1:15355 N NORTHSIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2603
Mailing Address - Country:US
Mailing Address - Phone:480-348-0401
Mailing Address - Fax:
Practice Address - Street 1:15355 N NORTHSIGHT BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2603
Practice Address - Country:US
Practice Address - Phone:480-348-0401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2022-12-22
Deactivation Date:2022-12-19
Deactivation Code:
Reactivation Date:2022-12-22
Provider Licenses
StateLicense IDTaxonomies
AZS026254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist