Provider Demographics
NPI:1558692418
Name:ALNOAH, FAHAD A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FAHAD
Middle Name:A
Last Name:ALNOAH
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 1:2231 S ELKS LN
Mailing Address - Street 2:UNIT 74
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6269
Mailing Address - Country:US
Mailing Address - Phone:610-212-2344
Mailing Address - Fax:928-341-9527
Practice Address - Street 1:2801 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8125
Practice Address - Country:US
Practice Address - Phone:928-344-0453
Practice Address - Fax:928-341-9527
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD05512588OtherDRIVER LICENSE