MEDICARE: MS. CONNIE ELIZABETH SHAWLER RPH

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	8368	AZ

General Provider Information

NPI Number	:	1255666442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CONNIE ELIZABETH SHAWLER RPH

Provider Business Mailing Address
First Line	:	7812 E SPEEDWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1649
Country	:	US
Telephone Number	:	520-885-3540
Fax Number	:	520-298-9264

Provider Business Practice Location Address
First Line	:	7812 E SPEEDWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1649
Country	:	US
Telephone Number	:	520-885-3540
Fax Number	:	520-298-9264

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

Provider Enumeration Date	:	10/06/2009
Last Update Date	:	10/06/2009

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