Provider Demographics
NPI:1063930188
Name:POGGEMEIER, ELISE (PHARMD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:POGGEMEIER
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 1:7025 E VIA SOLERI DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1266
Mailing Address - Country:US
Mailing Address - Phone:636-219-5360
Mailing Address - Fax:
Practice Address - Street 1:34402 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1226
Practice Address - Country:US
Practice Address - Phone:480-595-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist