Provider Demographics
NPI:1619207693
Name:MCCOY, JAY A (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:A
Last Name:MCCOY
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 1:8469 E MCDONALD DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-6335
Mailing Address - Country:US
Mailing Address - Phone:480-483-1045
Mailing Address - Fax:480-483-2753
Practice Address - Street 1:8469 E MCDONALD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-6335
Practice Address - Country:US
Practice Address - Phone:480-483-1045
Practice Address - Fax:480-483-2753
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS10659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist