MEDICARE: CLINTON ANDREW SLOVARP PHARMD

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	PH60451586	WA
2	183500000X	Pharmacist	P7053	ID

General Provider Information

NPI Number	:	1346657475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLINTON ANDREW SLOVARP PHARMD

Provider Business Mailing Address
First Line	:	5025 E SPRAGUE AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-0814
Country	:	US
Telephone Number	:	509-795-3601
Fax Number	:	509-534-1012

Provider Business Practice Location Address
First Line	:	5025 E SPRAGUE AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-0814
Country	:	US
Telephone Number	:	509-795-3601
Fax Number	:	509-534-1012

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

Provider Enumeration Date	:	07/21/2014
Last Update Date	:	07/21/2014

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