Provider Demographics
NPI:1588181622
Name:BILLINGTON, TANESS EYRE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TANESS
Middle Name:EYRE
Last Name:BILLINGTON
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 1:1625 E CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3901
Mailing Address - Country:US
Mailing Address - Phone:602-274-0810
Mailing Address - Fax:602-274-1132
Practice Address - Street 1:1625 E. CAMELBACK RD.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016
Practice Address - Country:US
Practice Address - Phone:602-274-0810
Practice Address - Fax:602-274-1132
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist