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General NPI Number Information
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NPI Number | 1194339747
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Entity Type | Individual
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Provider Name | MARCUS CAIDE HARDING PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 200 W HOSPITAL DR
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City | WHITERIVER
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State | AZ
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Zip | 85941
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Country | US
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Telephone | 928-338-3516
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Fax |
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Provider Business Mailing Address
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Address Line | 4495 STONE PINE DR
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City | PINETOP
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State | AZ
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Zip | 85935-8181
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Country | US
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Telephone | 520-979-8693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S023992
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License Number State | AZ
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