Provider Demographics
NPI:1508118761
Name:BOAKYE DANQUAH, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BOAKYE DANQUAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 S SOUTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-1973
Mailing Address - Country:US
Mailing Address - Phone:614-900-6181
Mailing Address - Fax:
Practice Address - Street 1:4735 S SOUTHWIND DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1973
Practice Address - Country:US
Practice Address - Phone:614-900-6181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist