Provider Demographics
NPI:1801121884
Name:MENGHANI, MANOJ G (PHARM D)
Entity type:Individual
Prefix:MR
First Name:MANOJ
Middle Name:G
Last Name:MENGHANI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5233 W ST KATERI DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6933
Mailing Address - Country:US
Mailing Address - Phone:602-358-7455
Mailing Address - Fax:
Practice Address - Street 1:5233 W ST KATERI DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6933
Practice Address - Country:US
Practice Address - Phone:602-358-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist