Provider Demographics
NPI:1962081802
Name:MCKEE, MARK A (RPH)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:MCKEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 N RURAL RD UNIT 152
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-6906
Mailing Address - Country:US
Mailing Address - Phone:480-677-9456
Mailing Address - Fax:
Practice Address - Street 1:5783 W ERIE ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2749
Practice Address - Country:US
Practice Address - Phone:480-365-0222
Practice Address - Fax:844-297-7327
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist