Provider Demographics
NPI:1417960832
Name:DAVID, JOE ALVIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:ALVIN
Last Name:DAVID
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 1:707 W SUMMIT PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1814
Mailing Address - Country:US
Mailing Address - Phone:480-820-2873
Mailing Address - Fax:
Practice Address - Street 1:707 W SUMMIT PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1814
Practice Address - Country:US
Practice Address - Phone:480-820-2873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist