Individual provider Active NPI

Fabrice Afanyu-Lorater, RPH.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Peridot, AZ
National Provider Identifier
1265929145
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
S022550 Issued in AZ
Practice address
103 Medicine Way Rd
Peridot, AZ 85542
Phone
(928) 475-1300
Fax
(928) 475-7376
NPI assigned
Apr 17, 2018
Last updated
Apr 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X S022550 AZ Primary

Addresses

Primary practice location

103 Medicine Way Rd
Peridot, AZ 85542

Mailing address

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1300

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
S022550AZMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1265929145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MEDICINE WAY RD",
            "city": "PERIDOT",
            "state": "AZ",
            "postal_code": "85542",
            "telephone_number": "928-475-1300",
            "fax_number": "928-475-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MEDICINE WAY RD",
            "city": "PERIDOT",
            "state": "AZ",
            "postal_code": "85542",
            "telephone_number": "928-475-1300",
            "fax_number": "928-475-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFANYU-LORATER",
        "first_name": "FABRICE",
        "credential": "RPH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AZ",
            "license": "S022550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peridot, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.