Doctor Name: | DR. LATOSHA MONIQUE MAYES |
NPI Number: | 1124285556 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHARM.D. |
License Number: | 051289463 |
Business Practice Address: | 3001 1a 6th Street Great Lakes, IL - 60088 |
Business Phone Number: | 8476884560 |
Business Fax Number: | |
Mailing Address: | 2120 Sunset Ln, SOUTH HOLLAND |
State: | IL |
Postal Code: | 604733773 |
Phone Number: | 7088950635 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2008 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1835P0018X |
License Number: | 051289463 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacist |
Taxonomy Specialization: | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Taxonomy Definition: | Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |