Provider Demographics
NPI:1801220793
Name:HOELZER, CHAD GARRETT (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:GARRETT
Last Name:HOELZER
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 1:520 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6554
Mailing Address - Country:US
Mailing Address - Phone:602-243-3014
Mailing Address - Fax:602-243-9092
Practice Address - Street 1:520 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6554
Practice Address - Country:US
Practice Address - Phone:602-243-3014
Practice Address - Fax:602-243-9092
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist