1740415983 NPI number — MARCELLA NICOLE HONKONEN PHARMD

Table of content: MARCELLA NICOLE HONKONEN PHARMD (NPI 1740415983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740415983 NPI number — MARCELLA NICOLE HONKONEN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HONKONEN
Provider First Name:
MARCELLA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOYLAND
Provider Other First Name:
MARCELLA
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740415983
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF ARIZONA PHARMACY PULIDO CTR
Provider Second Line Business Mailing Address:
1295 N. MARTIN AVE, P.O. BOX 210202
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85721-0202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-626-0499
Provider Business Mailing Address Fax Number:
520-626-7355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY OF ARIZONA PHARMACY PULIDO CTR
Provider Second Line Business Practice Location Address:
1295 N. MARTIN AVE
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85721-0202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-626-0499
Provider Business Practice Location Address Fax Number:
520-626-7355
Provider Enumeration Date:
05/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P0018X , with the licence number:  S019171 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: RP0007311 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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