Provider Demographics
NPI:1952924847
Name:MACKIE, CHERYL (RPH)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:MACKIE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 E MCDOWELL RD STE 201-206
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3867
Mailing Address - Country:US
Mailing Address - Phone:973-564-8004
Mailing Address - Fax:973-564-8010
Practice Address - Street 1:8010 E MCDOWELL RD STE 201-206
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3867
Practice Address - Country:US
Practice Address - Phone:973-564-8004
Practice Address - Fax:973-564-8010
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY007875333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy