Provider Demographics
NPI:1578963146
Name:ABRAHAM, ROSEANNE S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSEANNE
Middle Name:S
Last Name:ABRAHAM
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 1:11177 N ORACLE RD APT 11303
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-5654
Mailing Address - Country:US
Mailing Address - Phone:617-947-9173
Mailing Address - Fax:
Practice Address - Street 1:11177 N ORACLE RD APT 11303
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-5654
Practice Address - Country:US
Practice Address - Phone:617-947-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22461183500000X
AZS025662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist