Active NPI
Cynthia Maciak, RPH
- Pharmacist
- Green Valley, AZ
National Provider Identifier
1962738294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S019700
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| S019700 | AZ | MD | Pharmacist |
| 045173 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Pharmacy
- Peoria, AZ
- NPI 1134549181
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.