MEDICARE: DR. MICHAEL SCOTT HARDY 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	261QH0100X	Health Service Clinic/Center	14370	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14370	OTHER	AZ	AZ STATE

General Provider Information

NPI Number	:	1700117744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SCOTT HARDY PHARMD

Provider Business Mailing Address
First Line	:	3036 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-8014
Country	:	US
Telephone Number	:	602-468-9188
Fax Number	:	602-468-0939

Provider Business Practice Location Address
First Line	:	3036 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-8014
Country	:	US
Telephone Number	:	602-468-9188
Fax Number	:	602-468-0939

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

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	01/14/2010

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