MEDICARE: MIRANDA WOLF PHARMD

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
1	183500000X	Pharmacist	S027840	AZ

General Provider Information

NPI Number	:	1467049585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA WOLF PHARMD

Provider Business Mailing Address
First Line	:	360 N VAL VISTA DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-8624
Country	:	US
Telephone Number	:	480-807-0251
Fax Number	:	480-832-5379

Provider Business Practice Location Address
First Line	:	360 N VAL VISTA DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-8624
Country	:	US
Telephone Number	:	480-807-0251
Fax Number	:	480-832-5379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2020
Last Update Date	:	01/13/2026

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Directions to “ MIRANDA WOLF PHARMD” Practice Location

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