Provider Demographics
NPI:1700041050
Name:RHOADS, MARK (RPH, DBS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:RHOADS
Suffix:
Gender:M
Credentials:RPH, DBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2088 W BRITTAIN DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-4816
Mailing Address - Country:US
Mailing Address - Phone:520-449-3982
Mailing Address - Fax:
Practice Address - Street 1:2088 W BRITTAIN DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-4816
Practice Address - Country:US
Practice Address - Phone:520-449-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist