Provider Demographics
NPI:1972087310
Name:BRADY, TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BRADY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 W LYDIA LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-3054
Mailing Address - Country:US
Mailing Address - Phone:480-272-0960
Mailing Address - Fax:
Practice Address - Street 1:32351 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1513
Practice Address - Country:US
Practice Address - Phone:480-575-5910
Practice Address - Fax:480-282-9796
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023986183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist