Healthcare Provider Details

I. General information

NPI: 1477343291
Provider Name (Legal Business Name): MAKHAILA ESQUIBEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W 4TH ST
MISHAWAKA IN
46544-1948
US

IV. Provider business mailing address

117 W GROVE ST APT 204
MISHAWAKA IN
46545-6683
US

V. Phone/Fax

Practice location:
  • Phone: 574-307-7673
  • Fax:
Mailing address:
  • Phone: 505-688-1829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number26031095A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: