Provider Demographics
NPI:1356506984
Name:ARIAS, ARNOLD SERGEI (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:SERGEI
Last Name:ARIAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22489 N 102ND LANE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383
Mailing Address - Country:US
Mailing Address - Phone:623-334-4635
Mailing Address - Fax:623-334-4641
Practice Address - Street 1:22489 N 102ND LANE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383
Practice Address - Country:US
Practice Address - Phone:623-334-0721
Practice Address - Fax:623-334-4641
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist