Provider Demographics
NPI:1922764026
Name:LOPEZ, HENRY FRANK JR (PHARMD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:FRANK
Last Name:LOPEZ
Suffix:JR
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 1:888 E CLINTON ST APT 1018
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5803
Mailing Address - Country:US
Mailing Address - Phone:623-217-1890
Mailing Address - Fax:
Practice Address - Street 1:29455 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3245
Practice Address - Country:US
Practice Address - Phone:148-053-8713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist