MEDICARE: VIJAY MUKESH VORA PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	S018721	AZ

General Provider Information

NPI Number	:	1245511617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAY MUKESH VORA PHARM.D.

Provider Business Mailing Address
First Line	:	10705 W INDIAN SCHOOL RD
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85392-5636
Country	:	US
Telephone Number	:	623-332-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	10705 W INDIAN SCHOOL RD
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85392-5636
Country	:	US
Telephone Number	:	623-332-3331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	08/30/2011

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