Provider Demographics
NPI:1750611745
Name:SMOLJAN, CHARLES RAMAN (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RAMAN
Last Name:SMOLJAN
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 W THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-5948
Mailing Address - Country:US
Mailing Address - Phone:602-993-9900
Mailing Address - Fax:602-993-7824
Practice Address - Street 1:2610 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-5948
Practice Address - Country:US
Practice Address - Phone:602-993-9900
Practice Address - Fax:602-993-7824
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist