Provider Demographics
NPI:1235835745
Name:DEV, MAYUR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MAYUR
Middle Name:
Last Name:DEV
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4840
Mailing Address - Country:US
Mailing Address - Phone:480-444-8813
Mailing Address - Fax:
Practice Address - Street 1:5068 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1521
Practice Address - Country:US
Practice Address - Phone:602-275-5719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS012925OtherARIZONA STATE BOARD OF PHARMACY LICENSE NUMBER