Provider Demographics
NPI:1649596545
Name:VALLIN, ROSA LILIA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:LILIA
Last Name:VALLIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ROSA
Other - Middle Name:LILIA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7828 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4223
Mailing Address - Country:US
Mailing Address - Phone:602-331-5323
Mailing Address - Fax:602-331-2458
Practice Address - Street 1:7828 N 12TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4223
Practice Address - Country:US
Practice Address - Phone:602-331-5323
Practice Address - Fax:602-331-2458
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS013660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist