Provider Demographics
NPI:1760764740
Name:VAN ROOYEN, MARIA F (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:F
Last Name:VAN ROOYEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 E DESERT COVE AVE UNIT 154
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5399
Mailing Address - Country:US
Mailing Address - Phone:480-593-0293
Mailing Address - Fax:
Practice Address - Street 1:4925 E DESERT COVE AVE UNIT 154
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5399
Practice Address - Country:US
Practice Address - Phone:480-593-0293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS013920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist