Active NPI
Robert Itkoe
- Pharmacist
- Glendale, AZ
National Provider Identifier
1144643248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S006342
- Practice address
- 5605 W Northern Ave
Glendale, AZ 85301-1332 - Phone
- (623) 934-7926
- Fax
- (623) 934-7929
- NPI assigned
- Jan 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S006342 | AZ | Primary |
Addresses
Primary practice location
5605 W Northern Ave
Glendale, AZ 85301-1332
Mailing address
5605 W Northern Ave
Glendale, AZ 85301-1332
Phone (623) 934-7926
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S006342 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390521600000",
"number": "1144643248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5605 W NORTHERN AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853011332",
"telephone_number": "623-934-7926",
"fax_number": "623-934-7929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5605 W NORTHERN AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853011332",
"telephone_number": "623-934-7926",
"fax_number": "623-934-7929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITKOE",
"first_name": "ROBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-24",
"last_updated": "2014-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S006342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.