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General NPI Number Information
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NPI Number | 1710789748
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Entity Type | Individual
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Provider Name | MADANA KAMINENI PHARM D., MBA
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 20040 N 19TH AVE STE A
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City | PHOENIX
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State | AZ
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Zip | 85027-4256
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Country | US
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Telephone | 623-869-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1470 W LAUREL AVE
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City | GILBERT
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State | AZ
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Zip | 85233-4128
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Country | US
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Telephone |
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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 | S027119
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License Number State | AZ
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