Provider Demographics
NPI:1407335524
Name:BOLES, DONALD JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:JAMES
Last Name:BOLES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20622 N CAVE CREEK RD STE C-121
Mailing Address - Street 2:20622 N CAVE CREEK RD STE C-121
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024
Mailing Address - Country:US
Mailing Address - Phone:480-351-8278
Mailing Address - Fax:480-351-8277
Practice Address - Street 1:20622 N CAVE CREEK RD STE C-121
Practice Address - Street 2:20622 N CAVE CREEK RD STE C-121
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024
Practice Address - Country:US
Practice Address - Phone:480-351-8278
Practice Address - Fax:480-351-8277
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0226971835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care