MEDICARE: RICHARD HARTMANN RPH

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	S017049	AZ

General Provider Information

NPI Number	:	1518363126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD HARTMANN RPH

Provider Business Mailing Address
First Line	:	19403 N R H JOHNSON BLVD
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-4404
Country	:	US
Telephone Number	:	623-930-5050
Fax Number	:

Provider Business Practice Location Address
First Line	:	19403 N R H JOHNSON BLVD
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-4404
Country	:	US
Telephone Number	:	623-930-5050
Fax Number	:

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

Provider Enumeration Date	:	11/10/2014
Last Update Date	:	11/10/2014

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