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General NPI Number Information
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NPI Number | 1306327754
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Entity Type | Individual
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Provider Name | MOLLEY KAY GRANBERRY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 9950 E GUADALUPE RD
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City | MESA
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State | AZ
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Zip | 85212-2135
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Country | US
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Telephone | 480-354-3758
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Fax |
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Provider Business Mailing Address
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Address Line | 544 N ALMA SCHOOL RD UNIT 8
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City | MESA
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State | AZ
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Zip | 85201-5474
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Country | US
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Telephone | 520-234-3537
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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 | S023337
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License Number State | AZ
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