Provider Demographics
NPI:1619576584
Name:NORWOOD, CHARLES R (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:R
Last Name:NORWOOD
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 1:3932 E PACKARD AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-0815
Mailing Address - Country:US
Mailing Address - Phone:928-848-0493
Mailing Address - Fax:
Practice Address - Street 1:3970 N STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3002
Practice Address - Country:US
Practice Address - Phone:928-681-4903
Practice Address - Fax:928-681-4911
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist