M2D Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y00764 Issued in AZ

Legal business name

M2D PHARMACY, LLC

Doing business as

Four Corners Pharmacy

Practice address

21321 E Ocotillo Rd # B104
Queen Creek, AZ 85142-5996

Phone

(480) 534-1797

Fax

(480) 534-1799

NPI assigned

Jul 18, 2018

Organization subpart

No

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

Authorized official

Name

Dawn Hoang

Title

Member

Phone

(480) 534-1797

Specialties & licenses 2

Addresses

Other names 1

• FOUR CORNERS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1558847954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD # B104",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425996",
            "telephone_number": "480-534-1797",
            "fax_number": "480-534-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD # B104",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425996",
            "telephone_number": "480-534-1797",
            "fax_number": "480-534-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M2D PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-534-1797"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y00764",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AZ",
            "license": "Y00764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOUR CORNERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alex Keith Macdonald
• Crystal Emily Mack, PMHNP
• Joshua Mack, REGISTERED NURSE
• Kelsey Madden, FNP
• Cassie Maddigan

• Community/Retail Pharmacy in Queen Creek, AZ
• Providers in Queen Creek, 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 Jul 18, 2018; 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.