Healthcare Provider Details

I. General information

NPI: 1538548599
Provider Name (Legal Business Name): BELINDA MIKIC PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BELINDA MIKIC

II. Dates (important events)

Enumeration Date: 05/23/2015
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 E WATKINS ST
PHOENIX AZ
85034-7264
US

IV. Provider business mailing address

3809 E WATKINS ST
PHOENIX AZ
85034-7264
US

V. Phone/Fax

Practice location:
  • Phone: 855-745-5725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0015577
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021534
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: