Provider Demographics
NPI:1942621891
Name:CLAY, MICHAEL (BSHA, CPHT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CLAY
Suffix:
Gender:M
Credentials:BSHA, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20427 N 27TH AVE
Mailing Address - Street 2:MAIL STOP 4501
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3241
Mailing Address - Country:US
Mailing Address - Phone:623-869-3980
Mailing Address - Fax:623-336-6844
Practice Address - Street 1:20427 N 27TH AVE
Practice Address - Street 2:MAIL STOP 4501
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3241
Practice Address - Country:US
Practice Address - Phone:623-869-3980
Practice Address - Fax:623-336-6844
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician