Provider Demographics
NPI:1205181500
Name:MALONE, CHERYL ANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:MALONE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANNE
Other - Last Name:KNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9830 W LOWER BUCKEYE RD
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-1401
Mailing Address - Country:US
Mailing Address - Phone:623-687-2137
Mailing Address - Fax:623-696-3807
Practice Address - Street 1:9830 W LOWER BUCKEYE RD
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-1401
Practice Address - Country:US
Practice Address - Phone:623-687-2137
Practice Address - Fax:623-696-3807
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13768183500000X
AZS021026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4223171OtherNABP