Basic Information
Provider Information
NPI: 1740391937
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAM
FirstName: DENISE
MiddleName: CHUI-WA
NamePrefix:  
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 W FRYE RD
Address2:  
City: CHANDLER
State: AZ
PostalCode: 852244950
CountryCode: US
TelephoneNumber: 8886947287
FaxNumber:  
Practice Location
Address1: 2700 W FRYE RD
Address2:  
City: CHANDLER
State: AZ
PostalCode: 852244950
CountryCode: US
TelephoneNumber: 8886947287
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 12/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X14669AZY Pharmacy Service ProvidersPharmacist 
183500000XRP045280LPAN Pharmacy Service ProvidersPharmacist 
183500000X051.296484ILN Pharmacy Service ProvidersPharmacist 

No ID Information.


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