Provider Demographics
NPI:1538494745
Name:WIRICK, ANDREW STEPHEN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:STEPHEN
Last Name:WIRICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7614
Mailing Address - Country:US
Mailing Address - Phone:602-952-1491
Mailing Address - Fax:602-952-9310
Practice Address - Street 1:4505 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7614
Practice Address - Country:US
Practice Address - Phone:602-952-1491
Practice Address - Fax:602-952-9310
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist