Individual provider Active NPI

Cynthia Maciak, RPH

  • Pharmacist
  • Green Valley, AZ
National Provider Identifier
1962738294
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S019700 Issued in AZ
Practice address
240 W Continental Rd
Green Valley, AZ 85614
Phone
(520) 625-7286
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 045173 MO
Pharmacist 183500000X S019700 AZ Primary

Addresses

Primary practice location

240 W Continental Rd
Green Valley, AZ 85614

Mailing address

3205 W Cortaro Farms Rd
Unit 28
Tucson, AZ 85742-1200
Phone (314) 420-2415

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
S019700AZMDPharmacist
045173MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona CVS Stores LLC Past Accepting new patients

Organizations & group practices 1

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": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1962738294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 W CORTARO FARMS RD",
            "address_2": "UNIT 28",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857421200",
            "telephone_number": "314-420-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W CONTINENTAL RD",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "85614",
            "telephone_number": "520-625-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIAK",
        "first_name": "CYNTHIA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "045173",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.