MEDICARE: ALEXANDRA BARBARA PIATEK 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	12999	AZ

General Provider Information

NPI Number	:	1780700187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA BARBARA PIATEK PHARM D.

Provider Business Mailing Address
First Line	:	5860 W THUNDERBIRD RD
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4629
Country	:	US
Telephone Number	:	602-863-0015
Fax Number	:	602-863-0115

Provider Business Practice Location Address
First Line	:	35216 N 36TH PL
Second Line	:
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331-9546
Country	:	US
Telephone Number	:	602-373-4241
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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