Provider Demographics
NPI:1083426522
Name:TABAR, MANA
Entity type:Individual
Prefix:
First Name:MANA
Middle Name:
Last Name:TABAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7631 E INDIAN SCHOOL RD
Mailing Address - Street 2:4422
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3607
Mailing Address - Country:US
Mailing Address - Phone:800-331-8272
Mailing Address - Fax:
Practice Address - Street 1:7631 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3607
Practice Address - Country:US
Practice Address - Phone:800-331-8272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS027306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist