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General NPI Number Information
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NPI Number | 1205051919
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Entity Type | Individual
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Provider Name | KELLY MALOUF R.PH.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7400 E OSBORN RD DIRECTOR OF PHARMACY SERVICES
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6432
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Country | US
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Telephone | 480-882-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 10846 E LE MARCHE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-8822
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Country | US
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Telephone | 480-294-4546
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 13203
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License Number State | AZ
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