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General NPI Number Information
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NPI Number | 1366167355
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Entity Type | Individual
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Provider Name | MEGAN LE
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Gender | Female
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 7409 W VIRGINIA AVE
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City | PHOENIX
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State | AZ
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Zip | 85035-1336
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Country | US
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Telephone | 623-245-3033
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Fax |
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Provider Business Mailing Address
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Address Line | 23417 N 64TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85310-3401
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Country | US
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Telephone | 631-626-5701
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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 | S026079
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License Number State | AZ
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