Provider Demographics
NPI:1184397507
Name:KUBER, TRISHNA S (PHARMD)
Entity type:Individual
Prefix:
First Name:TRISHNA
Middle Name:S
Last Name:KUBER
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 1:3313 E DONALD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8237
Mailing Address - Country:US
Mailing Address - Phone:480-414-0809
Mailing Address - Fax:
Practice Address - Street 1:4500 E COTTON CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-8840
Practice Address - Country:US
Practice Address - Phone:860-900-4878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist