MEDICARE: PAUL J SHIECHEL B.S. PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13799	AZ

General Provider Information

NPI Number	:	1093861577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL J SHIECHEL B.S. PHARMACY

Provider Business Mailing Address
First Line	:	5332 E BASELINE RD APT 1072
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4723
Country	:	US
Telephone Number	:	480-236-5018
Fax Number	:

Provider Business Practice Location Address
First Line	:	3132 E CAMELBACK RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4502
Country	:	US
Telephone Number	:	602-957-4265
Fax Number	:	602-954-7412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/08/2007

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