MEDICARE: DR. MICHAEL RILEY 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	S012793	AZ

General Provider Information

NPI Number	:	1558691782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL RILEY PHARM-D

Provider Business Mailing Address
First Line	:	4801 E WASHINGTON ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-2004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 E WASHINGTON ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-2004
Country	:	US
Telephone Number	:	480-624-9282
Fax Number	:

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

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	04/17/2016

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