Provider Demographics
NPI:1295289700
Name:DARCY, KEVIN TIMOTHY (RPH)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:TIMOTHY
Last Name:DARCY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N KYRENE RD APT 236
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2786
Mailing Address - Country:US
Mailing Address - Phone:719-371-2287
Mailing Address - Fax:
Practice Address - Street 1:705 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2519
Practice Address - Country:US
Practice Address - Phone:602-258-4865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023580183500000X
GARPH029342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist