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NPI Code Detail

MEDICARE: DR. JAY MITCHELL PHARM.D

MEDICARE: DR. JAY MITCHELL PHARM.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS014875AZ

General Provider Information

NPI Number : 1306177894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY MITCHELL PHARM.D
Provider Business Mailing Address
First Line : 4315 E MAIN ST
Second Line :
City : MESA
State : AZ
Zip : 85205-8605
Country : US
Telephone Number : 480-654-0260
Fax Number : 480-654-0397
Provider Business Practice Location Address
First Line : 4315 E MAIN ST
Second Line :
City : MESA
State : AZ
Zip : 85205-8605
Country : US
Telephone Number : 480-654-0260
Fax Number : 480-654-0397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2010
Last Update Date : 01/22/2010

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