Healthcare Provider Details

I. General information

NPI: 1972839280
Provider Name (Legal Business Name): RUDY MOLINA JR. PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 E 22ND ST
TUCSON AZ
85711-5335
US

IV. Provider business mailing address

4150 E 22ND ST
TUCSON AZ
85711-5335
US

V. Phone/Fax

Practice location:
  • Phone: 520-571-2080
  • Fax: 520-514-2968
Mailing address:
  • Phone: 520-571-2080
  • Fax: 520-514-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS015614
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: