MEDICARE: NORMA JUNE JONES CPHT

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	183700000X	Pharmacy Technician	19	AZ

General Provider Information

NPI Number	:	1427113109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA JUNE JONES CPHT

Provider Business Mailing Address
First Line	:	3454 N MOBILE RD
Second Line	:
City	:	GOLDEN VALLEY
State	:	AZ
Zip	:	86413-8870
Country	:	US
Telephone Number	:	928-757-0618
Fax Number	:

Provider Business Practice Location Address
First Line	:	3454 N MOBILE RD
Second Line	:
City	:	GOLDEN VALLEY
State	:	AZ
Zip	:	86413-8870
Country	:	US
Telephone Number	:	928-757-0618
Fax Number	:

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

Provider Enumeration Date	:	12/24/2006
Last Update Date	:	07/08/2007

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