Provider Demographics
NPI:1730631334
Name:GREENBERG, VICTORIA LYNN (RPH)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11680 E SAHUARO DR
Mailing Address - Street 2:#1014
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4167
Mailing Address - Country:US
Mailing Address - Phone:602-881-2223
Mailing Address - Fax:
Practice Address - Street 1:11680 E SAHUARO DR
Practice Address - Street 2:#1014
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4167
Practice Address - Country:US
Practice Address - Phone:602-881-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-29
Last Update Date:2016-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist