Active NPI
Tina Pourshams-Manzouri, PHARMD
- Pharmacist
- Gilbert, AZ
National Provider Identifier
1265083596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023367
- Practice address
- 3230 E Chandler Heights Rd
Gilbert, AZ 85298-4261 - Phone
- (480) 214-4894
- NPI assigned
- Sep 27, 2019
- Last updated
- Sep 27, 2019
- Sex
- Female
- Sole proprietor
- No
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 | S023367 | AZ | Primary |
Addresses
Primary practice location
3230 E Chandler Heights Rd
Gilbert, AZ 85298-4261
Mailing address
4455 S Burma CT
Gilbert, AZ 85297-1395
Phone (480) 634-3731
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
| License | State | Type | Specialty |
|---|---|---|---|
| S023367 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
3230 E Chandler Heights Rd
Gilbert, AZ 85298
Phone (480) 214-4894
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569542400000",
"number": "1265083596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4455 S BURMA CT",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852971395",
"telephone_number": "480-634-3731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3230 E CHANDLER HEIGHTS RD",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852984261",
"telephone_number": "480-214-4894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POURSHAMS-MANZOURI",
"first_name": "TINA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-27",
"last_updated": "2019-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.