Provider Demographics
NPI:1588977680
Name:CZERWINSKI, JOSEPH FRANK (BS-PHARMACY)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANK
Last Name:CZERWINSKI
Suffix:
Gender:M
Credentials:BS-PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7614
Mailing Address - Country:US
Mailing Address - Phone:602-952-1491
Mailing Address - Fax:602-952-9310
Practice Address - Street 1:4505 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7614
Practice Address - Country:US
Practice Address - Phone:602-952-1491
Practice Address - Fax:602-952-9310
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-17
Last Update Date:2010-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ15703OtherARIZONA PHARMACY LIC . NO.