MEDICARE: DR. YVONNE CATHERINE HUCKLEBERRY 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	1835P1200X	Pharmacotherapy Pharmacist	S12856	AZ

General Provider Information

NPI Number	:	1861490294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE CATHERINE HUCKLEBERRY PHARMD

Provider Business Mailing Address
First Line	:	3577 E NUGGET CANYON PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-2213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3577 E NUGGET CANYON PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-2213
Country	:	US
Telephone Number	:	520-615-2644
Fax Number	:

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

Provider Enumeration Date	:	07/10/2005
Last Update Date	:	07/08/2007

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