Provider Demographics
NPI:1669896874
Name:GILLUND, STEPHANIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:GILLUND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N ESTRELLA PKWY
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2808
Mailing Address - Country:US
Mailing Address - Phone:623-925-9883
Mailing Address - Fax:623-925-9914
Practice Address - Street 1:1100 N ESTRELLA PKWY
Practice Address - Street 2:PHARMACY
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2808
Practice Address - Country:US
Practice Address - Phone:623-925-9883
Practice Address - Fax:623-925-9914
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist