MEDICARE: DARLENE BANZHAF 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	S018598	AZ
2	183500000X	Pharmacist	18116	NV

General Provider Information

NPI Number	:	1386072924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLENE BANZHAF PHARMD

Provider Business Mailing Address
First Line	:	10555 N ORACLE RD
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85737-9353
Country	:	US
Telephone Number	:	520-219-4151
Fax Number	:

Provider Business Practice Location Address
First Line	:	10555 N ORACLE RD
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85737-9353
Country	:	US
Telephone Number	:	520-219-4151
Fax Number	:

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

Provider Enumeration Date	:	10/16/2013
Last Update Date	:	10/16/2013

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