Provider Demographics
NPI:1437755949
Name:MICHAUD, JAMES J (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:MICHAUD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 W CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-4013
Mailing Address - Country:US
Mailing Address - Phone:928-200-1499
Mailing Address - Fax:
Practice Address - Street 1:9925 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-8325
Practice Address - Country:US
Practice Address - Phone:480-357-2634
Practice Address - Fax:480-373-2423
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS007086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist