Provider Demographics
NPI:1861775918
Name:GANZ, CHRISTOPHER AARON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:GANZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 POLE LINE RD
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3036
Mailing Address - Country:US
Mailing Address - Phone:208-736-1725
Mailing Address - Fax:208-736-7318
Practice Address - Street 1:731 POLE LINE RD
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3036
Practice Address - Country:US
Practice Address - Phone:208-736-1725
Practice Address - Fax:208-736-7318
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6224281-1701183500000X
IDP7689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist