MEDICARE: INTEL CORPORATION

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	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1487802765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEL CORPORATION

Provider Business Mailing Address
First Line	:	1375 E 9TH ST
Second Line	:	25TH FLOOR
City	:	CLEVELAND
State	:	OH
Zip	:	44114-1739
Country	:	US
Telephone Number	:	216-589-9400
Fax Number	:	216-589-9445

Provider Business Practice Location Address
First Line	:	4500 S DOBSON RD
Second Line	:	MAIL STOP: OC2-112
City	:	CHANDLER
State	:	AZ
Zip	:	85248-4907
Country	:	US
Telephone Number	:	480-715-6112
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. RANDALL L TWYMAN
Credential	:	CPA
Telephone Number	:	216-589-9400

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	08/29/2008

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