Individual provider Active NPI

Tianning Liu, PHARM.D

  • Pharmacist
  • Fort Mohave, AZ
National Provider Identifier
1366814014
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S021658 Issued in AZ
Practice address
4744 S Highway 95
Fort Mohave, AZ 86426-9377
Phone
(928) 763-6822
Fax
(928) 763-6817
NPI assigned
Oct 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S021658 AZ Primary

Addresses

Primary practice location

4744 S Highway 95
Fort Mohave, AZ 86426-9377

Mailing address

4744 S Highway 95
Fort Mohave, AZ 86426-9377
Phone (928) 763-6822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S021658AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona CVS Stores, L.L.C. Past Accepting new patients
Arizona CVS Stores LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1366814014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4744 S HIGHWAY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269377",
            "telephone_number": "928-763-6822",
            "fax_number": "928-763-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 S HIGHWAY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269377",
            "telephone_number": "928-763-6822",
            "fax_number": "928-763-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "TIANNING",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S021658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mohave, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.