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NPI Code Detail

MEDICARE: MR. MARK PIACQUADIO

MEDICARE: MR. MARK PIACQUADIO
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
1183500000XPharmacistS013598AZ

General Provider Information

NPI Number : 1417355991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK PIACQUADIO
Provider Business Mailing Address
First Line : 6470 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85298-4341
Country : US
Telephone Number : 480-840-9562
Fax Number :
Provider Business Practice Location Address
First Line : 6470 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85298-4341
Country : US
Telephone Number : 480-840-9562
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2014
Last Update Date : 12/15/2014

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