Provider Demographics
NPI:1700112893
Name:HENGLEFELT, JANET ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ANN
Last Name:HENGLEFELT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-9700
Mailing Address - Country:US
Mailing Address - Phone:623-907-4938
Mailing Address - Fax:
Practice Address - Street 1:4025 E THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5836
Practice Address - Country:US
Practice Address - Phone:602-953-3540
Practice Address - Fax:602-494-9467
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS007332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist