Organization
ST. JAMES MTM PHARMACY, LLC
Active
Organization
ST. JAMES MTM PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN MARASIGAN MD (DIRECTOR, LLC MANAGER)
(480) 662-3865
Entity
Organization
Contact information
Practice address
3954 E WALLER LN, PHOENIX, AZ 85050-4916
(480) 662-3865
Mailing address
20624 N CAVE CREEK RD STE 142, STE 142, PHOENIX, AZ 85024-4453
(480) 662-3865
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
S014670
AZ
208D00000X
General Practice Physician
MD47798
AZ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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