Provider Demographics
NPI:1578369328
Name:BOSKIE, BRAD (PHARMD)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:BOSKIE
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 E FRIESS DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5316
Mailing Address - Country:US
Mailing Address - Phone:480-268-4061
Mailing Address - Fax:
Practice Address - Street 1:4 TECHNOLOGY DR STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-5314
Practice Address - Country:US
Practice Address - Phone:855-847-3553
Practice Address - Fax:855-847-3558
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0265911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist