Individual
MR. MICHAEL JOSEPH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1551 W ST MARYS RD, SAFEWAY # 255, TUCSON, AZ 85745-3107
(520) 624-8230
(520) 624-8724
Mailing address
3901 N AVENIDA LA VALLITA, TUCSON, AZ 85750
(520) 733-7489
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9959
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0317099
NABP
AZ
01
—
307191
AHCCCS
AZ
Enumeration date
02/27/2007
Last updated
07/08/2007
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