Provider Demographics
NPI:1821497173
Name:MOODLEY, SALOSHANIE
Entity Type:Individual
Prefix:MRS
First Name:SALOSHANIE
Middle Name:
Last Name:MOODLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12875 E MERCER LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4454
Mailing Address - Country:US
Mailing Address - Phone:480-495-4028
Mailing Address - Fax:
Practice Address - Street 1:2700 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4950
Practice Address - Country:US
Practice Address - Phone:480-899-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ014397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist