Provider Demographics
NPI:1508230376
Name:MAURO, JOSEPH A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:MAURO
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 1:23620 N 20TH DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0621
Mailing Address - Country:US
Mailing Address - Phone:877-546-5779
Mailing Address - Fax:
Practice Address - Street 1:23620 N 20TH DR
Practice Address - Street 2:SUITE 12
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0621
Practice Address - Country:US
Practice Address - Phone:877-546-5779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist