Provider Demographics
NPI:1871700237
Name:LEE, JANICE (PHARMD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:LEE
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 1:2820 E TINA LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-5741
Mailing Address - Country:US
Mailing Address - Phone:480-272-9164
Mailing Address - Fax:
Practice Address - Street 1:51 W 3RD ST
Practice Address - Street 2:SUITE 501
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2831
Practice Address - Country:US
Practice Address - Phone:877-882-7820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist