Provider Demographics
NPI:1750059754
Name:KING, TAYLER (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLER
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E VAN BUREN ST APT 3069
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-4042
Mailing Address - Country:US
Mailing Address - Phone:845-401-8660
Mailing Address - Fax:
Practice Address - Street 1:6640 W HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-2612
Practice Address - Country:US
Practice Address - Phone:623-561-5947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist