Provider Demographics
NPI:1457725319
Name:BELTZ, AMISHA PATEL
Entity Type:Individual
Prefix:
First Name:AMISHA
Middle Name:PATEL
Last Name:BELTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10653 N SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5263
Mailing Address - Country:US
Mailing Address - Phone:480-998-3500
Mailing Address - Fax:
Practice Address - Street 1:5954 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-9607
Practice Address - Country:US
Practice Address - Phone:480-830-4518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57718183500000X
AZS024387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist