Basic Information
| Provider Information | |||||||||
| NPI: | 1245349174 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARRIOLA | ||||||||
| FirstName: | OSMUND | ||||||||
| MiddleName: | GREGORY | ||||||||
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| Credential: | PHARM. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1790 N IRON SPRINGS LN | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863052141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287760953 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 N US HIGHWAY 89 | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863135001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9284454860 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 40687 | CA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.