MEDICARE: DR. RICHARD ENGLAND III PHARM D.

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	S017353	AZ

General Provider Information

NPI Number	:	1700255494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ENGLAND III PHARM D.

Provider Business Mailing Address
First Line	:	20125 N. 8TH WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024
Country	:	US
Telephone Number	:	623-815-8965
Fax Number	:	623-815-1222

Provider Business Practice Location Address
First Line	:	925 E COVEY LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-5674
Country	:	US
Telephone Number	:	623-815-8965
Fax Number	:	623-815-1222

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

Provider Enumeration Date	:	09/23/2015
Last Update Date	:	09/03/2020

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