Provider Demographics
NPI:1184397515
Name:RYAN, ARNE JOHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ARNE
Middle Name:JOHAN
Last Name:RYAN
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 1:18582 W COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-4014
Mailing Address - Country:US
Mailing Address - Phone:602-366-0568
Mailing Address - Fax:
Practice Address - Street 1:4500 E COTTON CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-8840
Practice Address - Country:US
Practice Address - Phone:602-659-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist