Provider Demographics
NPI:1194852236
Name:LIND, MINDY G (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:G
Last Name:LIND
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28455 N VISTANCIA BLVD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2087
Mailing Address - Country:US
Mailing Address - Phone:623-271-7617
Mailing Address - Fax:623-271-7728
Practice Address - Street 1:28455 N VISTANCIA BLVD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2087
Practice Address - Country:US
Practice Address - Phone:623-271-7617
Practice Address - Fax:623-271-7728
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist