Provider Demographics
NPI:1962950063
Name:ALEMAN CONTRERAS, JOHN (PHARM D)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ALEMAN CONTRERAS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:ALEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:901 WILLOW LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-4617
Mailing Address - Country:US
Mailing Address - Phone:928-771-0278
Mailing Address - Fax:
Practice Address - Street 1:901 WILLOW LAKE RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-4617
Practice Address - Country:US
Practice Address - Phone:928-771-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2016-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist