Provider Demographics
NPI:1861936460
Name:SANCHEZ, MERCEDES
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 W BASELINE RD
Mailing Address - Street 2:APT 1125
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5903
Mailing Address - Country:US
Mailing Address - Phone:773-308-4471
Mailing Address - Fax:
Practice Address - Street 1:750 W BASELINE RD
Practice Address - Street 2:APT 1125
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5903
Practice Address - Country:US
Practice Address - Phone:773-308-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist