St. James MTM Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ST. JAMES MTM PHARMACY, LLC

Practice address

3954 E Waller LN
Phoenix, AZ 85050-4916

Phone

(480) 662-3865

NPI assigned

Apr 13, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brian Marasigan, MD

Title

Director, LLC Manager

Phone

(480) 662-3865

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1346774619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20624 N CAVE CREEK RD STE 142",
            "address_2": "STE 142",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244453",
            "telephone_number": "480-662-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3954 E WALLER LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504916",
            "telephone_number": "480-662-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES MTM PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "MARASIGAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DIRECTOR, LLC MANAGER",
        "authorized_official_telephone_number": "480-662-3865",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S014670",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "MD47798",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.