Most Relevant Information
Provider Data
| NPI Number: | 1003210428 |
| Provider Name: | CHANNARONG JARUVANGSANTI PHARM D. |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | S010041 |
Most Important Dates
| Enumeration Date: | 10/14/2014 |
| Last Updated: | 10/14/2014 |
Provider Practice Location
408 W AIRE LIBRE AVE
PHOENIX
AZ
850237923
Practice Location Phone/Fax
| Phone: | 6024813328 |
| Fax: |
Provider Mailing Location
408 W AIRE LIBRE AVE
PHOENIX
AZ
850237923
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |