Active NPI
Alan Itzen, RPH
- Pharmacist
- Kayenta, AZ
National Provider Identifier
1679947501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 370
- Practice address
- Ka-2010 Hwy-163
Kayenta, AZ 86033-0368 - Phone
- (928) 697-4165
- NPI assigned
- Nov 16, 2015
- Sex
- Male
- 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 | 370 | VI | Primary |
Addresses
Primary practice location
Ka-2010 Hwy-163
Kayenta, AZ 86033-0368
Mailing address
Ka-2010 Hwy-163
Kayenta, AZ 86033
Phone (928) 697-4305
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
| License | State | Type | Specialty |
|---|---|---|---|
| 370 | VI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1679947501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "KA-2010 HWY-163",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "86033",
"telephone_number": "928-697-4305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "KA-2010 HWY-163",
"city": "KAYENTA",
"state": "AZ",
"postal_code": "860330368",
"telephone_number": "928-697-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITZEN",
"first_name": "ALAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VI",
"license": "370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.