Provider Demographics
NPI:1376980292
Name:FERRILL, KEVIN ERIC (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ERIC
Last Name:FERRILL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9131 W ALBERT LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-5358
Mailing Address - Country:US
Mailing Address - Phone:623-332-9133
Mailing Address - Fax:
Practice Address - Street 1:7455 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6035
Practice Address - Country:US
Practice Address - Phone:623-878-7998
Practice Address - Fax:623-878-9666
Is Sole Proprietor?:No
Enumeration Date:2013-06-01
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist