Provider Demographics
NPI:1083019251
Name:ALVAREZ, MICHELLE ELYA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELYA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:ELYA
Other - Last Name:EGGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:6002 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8928
Mailing Address - Country:US
Mailing Address - Phone:480-467-9543
Mailing Address - Fax:480-396-0497
Practice Address - Street 1:6002 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8928
Practice Address - Country:US
Practice Address - Phone:480-467-9543
Practice Address - Fax:480-396-0497
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist