Provider Demographics
NPI:1467773887
Name:VARGAS, REGINA LYNN (PHARMACY TECHICIAN)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:LYNN
Last Name:VARGAS
Suffix:
Gender:F
Credentials:PHARMACY TECHICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 S 151ST AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2949
Mailing Address - Country:US
Mailing Address - Phone:623-594-2145
Mailing Address - Fax:
Practice Address - Street 1:277 S 151ST AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2949
Practice Address - Country:US
Practice Address - Phone:623-594-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZT005013183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician