Provider Demographics
NPI:1245395326
Name:SAMSON, LINDA ANN (PHARM D)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:SAMSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12033 AGENCY RD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:AZ
Mailing Address - Zip Code:85344-7718
Mailing Address - Country:US
Mailing Address - Phone:928-669-3339
Mailing Address - Fax:928-669-3333
Practice Address - Street 1:1505 S OCOTILLO AVE
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-6235
Practice Address - Country:US
Practice Address - Phone:928-575-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20052183500000X
MD11666183500000X
VA0202007916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist