Provider Demographics
NPI:1992259618
Name:PELLERITO, JOSEPH BRENDIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRENDIN
Last Name:PELLERITO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 N CAMINO MIRAMONTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4946
Mailing Address - Country:US
Mailing Address - Phone:520-891-6599
Mailing Address - Fax:
Practice Address - Street 1:5085 N LA CANADA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1508
Practice Address - Country:US
Practice Address - Phone:520-696-0346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist