Provider Demographics
NPI:1710430293
Name:GEVERGIZIAN, ANOIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANOIEL
Middle Name:
Last Name:GEVERGIZIAN
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 1:2001 W CAMELBACK RD
Mailing Address - Street 2:STE 290
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3466
Mailing Address - Country:US
Mailing Address - Phone:844-866-3730
Mailing Address - Fax:
Practice Address - Street 1:2001 W CAMELBACK RD
Practice Address - Street 2:STE 290
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015
Practice Address - Country:US
Practice Address - Phone:844-866-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0016634183500000X
MI5302045832183500000X
DEA1-0005027183500000X
OK17227183500000X
TN43970183500000X
MD26139183500000X
KY020121183500000X
AZS021985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist