Provider Demographics
NPI:1922308725
Name:MAXSON, AARON M (RPH)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:M
Last Name:MAXSON
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 1:3755 E SAN PEDRO PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5283
Mailing Address - Country:US
Mailing Address - Phone:480-588-5225
Mailing Address - Fax:
Practice Address - Street 1:1225 W GUADALUPE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-9101
Practice Address - Country:US
Practice Address - Phone:480-838-7720
Practice Address - Fax:480-820-4202
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS12093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist