Provider Demographics
NPI:1467636043
Name:MARTIN, ROSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 N MOUNTAIN AVE
Mailing Address - Street 2:#2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2637
Mailing Address - Country:US
Mailing Address - Phone:520-861-7976
Mailing Address - Fax:
Practice Address - Street 1:THE UNIVERSITY OF ARIZONA COLLEGE OF PHARMACY
Practice Address - Street 2:1295 N MARTIN AVE B207
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0001
Practice Address - Country:US
Practice Address - Phone:520-626-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist