Provider Demographics
NPI:1750773040
Name:FRANCO, MAURICIO ALEXANDER (RPH)
Entity type:Individual
Prefix:
First Name:MAURICIO
Middle Name:ALEXANDER
Last Name:FRANCO
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 1:2320 W PEORIA AVE
Mailing Address - Street 2:SUITE D-132
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4753
Mailing Address - Country:US
Mailing Address - Phone:877-678-5400
Mailing Address - Fax:877-678-5401
Practice Address - Street 1:2320 W PEORIA AVE
Practice Address - Street 2:SUITE D-132
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4753
Practice Address - Country:US
Practice Address - Phone:877-678-5400
Practice Address - Fax:877-678-5401
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS009951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist