Provider Demographics
NPI:1447626411
Name:SANOVICH, CORINNE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:
Last Name:SANOVICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19505 N SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4739
Mailing Address - Country:US
Mailing Address - Phone:623-556-4778
Mailing Address - Fax:623-556-4787
Practice Address - Street 1:19505 N SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4739
Practice Address - Country:US
Practice Address - Phone:623-556-4778
Practice Address - Fax:623-556-4787
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist