Provider Demographics
NPI:1336366186
Name:CRITTENDEN, STEVEN L (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:CRITTENDEN
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 1:1048 S BUTTE LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3739
Mailing Address - Country:US
Mailing Address - Phone:480-814-1768
Mailing Address - Fax:
Practice Address - Street 1:51 W 3RD ST
Practice Address - Street 2:SUITE 501
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2831
Practice Address - Country:US
Practice Address - Phone:480-317-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist