Individual provider Active NPI

Tracy Thao Thach Lin, PHARMD

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1417188657
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S017282 Issued in AZ
Practice address
6811 E Superstition Springs Blvd
Mesa, AZ 85209-4001
Phone
(480) 641-4027
NPI assigned
Aug 5, 2009
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S017282 AZ Primary

Addresses

Primary practice location

6811 E Superstition Springs Blvd
Mesa, AZ 85209-4001

Mailing address

6811 E Superstition Springs Blvd
Mesa, AZ 85209-4001
Phone (480) 641-4027

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
S017282AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1417188657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6811 E SUPERSTITION SPRINGS BLVD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094001",
            "telephone_number": "480-641-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 E SUPERSTITION SPRINGS BLVD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094001",
            "telephone_number": "480-641-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "TRACY THAO",
        "middle_name": "THACH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.