Provider Demographics
NPI:1659962348
Name:LEWIS, JULIA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:FREBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2612 E RUSTLING OAKS LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-5280
Mailing Address - Country:US
Mailing Address - Phone:602-799-0948
Mailing Address - Fax:
Practice Address - Street 1:1850 W DUNLAP AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2943
Practice Address - Country:US
Practice Address - Phone:602-861-1537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist