Provider Demographics
NPI:1619372653
Name:JOSEPH, SOPHI (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SOPHI
Middle Name:
Last Name:JOSEPH
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 1:5225 S MONTE VISTA ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3337
Mailing Address - Country:US
Mailing Address - Phone:586-596-8559
Mailing Address - Fax:
Practice Address - Street 1:990 E PECOS RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2461
Practice Address - Country:US
Practice Address - Phone:480-857-2508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSO18377183500000X
MI5302036419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist