Provider Demographics
NPI:1710217849
Name:MACDONALD, HOWARD HORACE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:HORACE
Last Name:MACDONALD
Suffix:JR
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 1:7059 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-4803
Mailing Address - Country:US
Mailing Address - Phone:480-830-1554
Mailing Address - Fax:480-830-0473
Practice Address - Street 1:7059 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-4803
Practice Address - Country:US
Practice Address - Phone:480-830-1554
Practice Address - Fax:480-830-0473
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS008078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist