Healthcare Provider Details

I. General information

NPI: 1235464397
Provider Name (Legal Business Name): LAURA R LATIMER PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5941 E MCKELLIPS RD
MESA AZ
85215-2754
US

IV. Provider business mailing address

500 S 99TH AVE
TOLLESON AZ
85353-9700
US

V. Phone/Fax

Practice location:
  • Phone: 480-830-6343
  • Fax: 480-981-0156
Mailing address:
  • Phone: 623-907-4938
  • Fax: 480-988-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS017217
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS017217
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: