Provider Demographics
NPI:1417387309
Name:WELKER, CORTNEY (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:CORTNEY
Middle Name:
Last Name:WELKER
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 1:3831 E ELMWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-5171
Mailing Address - Country:US
Mailing Address - Phone:801-232-7808
Mailing Address - Fax:
Practice Address - Street 1:4420 E BROWN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4001
Practice Address - Country:US
Practice Address - Phone:480-396-8193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist