Julius Asofar Anumbosi

Individual provider Active NPI Pharmacist · Peridot, AZ

NPI 1508353301 · NPPES record last updated Apr 17, 2018

Key facts

NPI
1508353301
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
0004888 (DE)
Practice address
103 Medicine Way Rd
Peridot, AZ 85542
Phone
(928) 475-1300
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0004888DEMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0004888 DE Yes

Addresses

Primary practice location

103 Medicine Way Rd
Peridot, AZ 85542

Mailing address

PO Box 442
Peridot, AZ 85542-0442
Phone (240) 520-2534

Other names

  • Julius Asofar Former name

Other providers in Peridot, AZ

All providers in Peridot, AZ · Pharmacist in Arizona

Sources for this page

Verify at the official NPI Registry.