Provider Demographics
NPI:1013242221
Name:MELATPARAST, AFSANEH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AFSANEH
Middle Name:
Last Name:MELATPARAST
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20427 N HAYDEN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3874
Mailing Address - Country:US
Mailing Address - Phone:480-419-2273
Mailing Address - Fax:480-419-2267
Practice Address - Street 1:20427 N HAYDEN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3874
Practice Address - Country:US
Practice Address - Phone:480-419-2273
Practice Address - Fax:480-419-2267
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS010821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist