Provider Demographics
NPI:1740599521
Name:MARQUEZ, HENRY PEREZ (RPH)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:PEREZ
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18660 N. CAVE CREEK RD.
Mailing Address - Street 2:#125
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024
Mailing Address - Country:US
Mailing Address - Phone:602-788-2137
Mailing Address - Fax:
Practice Address - Street 1:1815 W GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-8582
Practice Address - Country:US
Practice Address - Phone:602-335-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS005788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist