Active NPI
Luu Phan
- Pharmacist
- Surprise, AZ
National Provider Identifier
1760994362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S022830
- Practice address
- 14285 W Grand Ave
Surprise, AZ 85374-4297 - Phone
- (623) 975-3944
- NPI assigned
- Nov 4, 2017
- Last updated
- Nov 4, 2017
- 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 | S022830 | AZ | Primary |
Addresses
Primary practice location
14285 W Grand Ave
Surprise, AZ 85374-4297
Mailing address
555 N College Ave Apt 2011
Tempe, AZ 85281-0187
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 |
|---|---|---|---|
| S022830 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1509753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509753600000",
"number": "1760994362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 N COLLEGE AVE APT 2011",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852810187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14285 W GRAND AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853744297",
"telephone_number": "623-975-3944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "LUU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-04",
"last_updated": "2017-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S022830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.