Provider Demographics
NPI:1386078087
Name:HINOJOSA, MARY YVONNE (PHARMD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:YVONNE
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:YVONNE
Other - Last Name:BELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 1548
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-1010
Mailing Address - Country:US
Mailing Address - Phone:520-393-1664
Mailing Address - Fax:
Practice Address - Street 1:17235 S IRVING AVE
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629
Practice Address - Country:US
Practice Address - Phone:520-393-1664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS09823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS09823OtherPHARMACIST LICENSE