Provider Demographics
NPI:1558077743
Name:RIGGERT, EVAN CHRISTIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:CHRISTIAN
Last Name:RIGGERT
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 1:2362 E KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86404-5918
Mailing Address - Country:US
Mailing Address - Phone:530-200-2220
Mailing Address - Fax:
Practice Address - Street 1:1500 E CEDAR AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1641
Practice Address - Country:US
Practice Address - Phone:928-774-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist