Provider Demographics
NPI:1780401638
Name:HART, ASHLEE (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:HART
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 1:3344 W WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1034
Mailing Address - Country:US
Mailing Address - Phone:602-463-2885
Mailing Address - Fax:
Practice Address - Street 1:19505 N SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4739
Practice Address - Country:US
Practice Address - Phone:623-556-4778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS027237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist