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General NPI Number Information
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NPI Number | 1558847954
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Entity Type | Organization
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Legal Business Name | M2D PHARMACY, LLC
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 21321 E OCOTILLO RD # B104
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-5996
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Country | US
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Telephone | 480-534-1797
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Fax | 480-534-1799
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Provider Business Mailing Address
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Address Line | 21321 E OCOTILLO RD # B104
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-5996
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Country | US
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Telephone | 480-534-1797
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Fax | 480-534-1799
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Authorized Official
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Title or Position | MEMBER
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Name | DAWN HOANG
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Credential |
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Telephone | 480-534-1797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | Y00764
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y00764
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License Number State | AZ
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