Provider Demographics
NPI:1356641435
Name:KOLP, ANDREW JONATHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JONATHAN
Last Name:KOLP
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 1:11275 E VIA LINDA
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4073
Mailing Address - Country:US
Mailing Address - Phone:480-451-1177
Mailing Address - Fax:480-614-1214
Practice Address - Street 1:11275 E VIA LINDA
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4073
Practice Address - Country:US
Practice Address - Phone:480-451-1177
Practice Address - Fax:480-614-1214
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist