MEDICARE: MR. MANOJ G MENGHANI 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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	S014896	AZ

General Provider Information

NPI Number	:	1801121884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MANOJ G MENGHANI PHARM D

Provider Business Mailing Address
First Line	:	5233 W ST KATERI DR
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-6933
Country	:	US
Telephone Number	:	602-358-7455
Fax Number	:

Provider Business Practice Location Address
First Line	:	5233 W ST KATERI DR
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-6933
Country	:	US
Telephone Number	:	602-358-7455
Fax Number	:

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

Provider Enumeration Date	:	10/09/2009
Last Update Date	:	06/20/2026

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