Healthcare Provider Details

I. General information

NPI: 1558784066
Provider Name (Legal Business Name): KEVIN DEY PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 02/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 E CHANDLER BLVD
CHANDLER AZ
85225-5110
US

IV. Provider business mailing address

2701 W ERIE ST
CHANDLER AZ
85224-4155
US

V. Phone/Fax

Practice location:
  • Phone: 480-899-8050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS020143
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: