Provider Demographics
NPI:1659987188
Name:ELAMIN, DUAA (RPH)
Entity Type:Individual
Prefix:
First Name:DUAA
Middle Name:
Last Name:ELAMIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 LOS LAGOS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-6653
Mailing Address - Country:US
Mailing Address - Phone:714-331-0309
Mailing Address - Fax:
Practice Address - Street 1:75 LAKE HAVASU AVE N
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5651
Practice Address - Country:US
Practice Address - Phone:928-854-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist