Provider Demographics
NPI:1588407910
Name:MORKOS, MARIAM (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARIAM
Middle Name:
Last Name:MORKOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WHITLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212-2226
Mailing Address - Country:US
Mailing Address - Phone:559-992-8020
Mailing Address - Fax:
Practice Address - Street 1:1500 WHITLEY AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-2226
Practice Address - Country:US
Practice Address - Phone:559-992-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist