Provider Demographics
NPI:1518274596
Name:MIHALKA, BRIAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MIHALKA
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 1:1900 W VALENCIA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-6628
Mailing Address - Country:US
Mailing Address - Phone:520-807-2288
Mailing Address - Fax:520-807-5361
Practice Address - Street 1:1900 W VALENCIA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6628
Practice Address - Country:US
Practice Address - Phone:520-807-2288
Practice Address - Fax:520-807-5361
Is Sole Proprietor?:No
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist