Provider Demographics
NPI:1578204764
Name:LOUDGHIRI, GHYZLANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GHYZLANE
Middle Name:
Last Name:LOUDGHIRI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8985 S DURANGO DR UNIT 2176
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-6138
Mailing Address - Country:US
Mailing Address - Phone:201-966-3815
Mailing Address - Fax:
Practice Address - Street 1:131 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-5221
Practice Address - Country:US
Practice Address - Phone:928-669-6168
Practice Address - Fax:928-669-8349
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV21016183500000X
AZS025722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist