Organization
MOJAVE MEDICATION MANAGEMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNIE BACON PHARMD. (PHARMACIST)
(282) 960-2389
Entity
Organization
Contact information
Practice address
2328 RYAN WAY, BULLHEAD CITY, AZ 86442-8699
(928) 296-0238
Mailing address
2328 RYAN WAY, BULLHEAD CITY, AZ 86442-8699
(702) 292-3798
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
—
—
Other
Enumeration date
07/19/2025
Last updated
07/19/2025
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