Individual provider Active NPI

Coreen Apayor Gallibu, PHARM.D.

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1073323952
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S027367 Issued in AZ
Practice address
4040 N 19TH Ave
Phoenix, AZ 85015-5303
Phone
(602) 265-3167
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S027367 AZ Primary

Addresses

Primary practice location

4040 N 19TH Ave
Phoenix, AZ 85015-5303

Mailing address

17722 N 79TH Ave Apt 2031
Glendale, AZ 85308-8677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S027367AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
German Dobson CVS LLC PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1073323952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17722 N 79TH AVE APT 2031",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155303",
            "telephone_number": "602-265-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIBU",
        "first_name": "COREEN",
        "middle_name": "APAYOR",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S027367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.