Provider Demographics
NPI:1467768630
Name:PEREGRIN, SUMMER FAYE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:FAYE
Last Name:PEREGRIN
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 1:2280 E INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1600
Mailing Address - Country:US
Mailing Address - Phone:480-219-9194
Mailing Address - Fax:
Practice Address - Street 1:2927 N 7TH AVE
Practice Address - Street 2:PEPPERTREE - FMC
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4102
Practice Address - Country:US
Practice Address - Phone:602-406-5113
Practice Address - Fax:602-294-5593
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0128091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist