Provider Demographics
NPI:1013382035
Name:MAKOWSKY, JOHN (RPHN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MAKOWSKY
Suffix:
Gender:M
Credentials:RPHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14307 S AVENUE 4 E
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-9360
Mailing Address - Country:US
Mailing Address - Phone:928-580-1688
Mailing Address - Fax:
Practice Address - Street 1:2501 S AVENUE B
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7734
Practice Address - Country:US
Practice Address - Phone:928-317-6863
Practice Address - Fax:928-317-6869
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0113881835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist