Provider Demographics
NPI:1063742286
Name:BOHANNON, RIHANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:RIHANNE
Middle Name:
Last Name:BOHANNON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4134 N 44TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-4217
Mailing Address - Country:US
Mailing Address - Phone:602-954-9119
Mailing Address - Fax:602-954-9229
Practice Address - Street 1:4134 N 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-4217
Practice Address - Country:US
Practice Address - Phone:602-954-9119
Practice Address - Fax:602-954-9229
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist