Provider Demographics
NPI:1790197127
Name:EL-GENDY, SHAIMAA
Entity Type:Individual
Prefix:
First Name:SHAIMAA
Middle Name:
Last Name:EL-GENDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 E COMSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1892
Mailing Address - Country:US
Mailing Address - Phone:614-260-6610
Mailing Address - Fax:
Practice Address - Street 1:1212 S GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2792
Practice Address - Country:US
Practice Address - Phone:480-654-8920
Practice Address - Fax:480-924-6267
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist