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NPI Code Detail

MEDICARE: JEFFREY GOYETTE STEVENS RPH

MEDICARE: JEFFREY GOYETTE STEVENS 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
1183500000XPharmacistS021404AZ

General Provider Information

NPI Number : 1871961862
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY GOYETTE STEVENS RPH
Provider Business Mailing Address
First Line : 1200 E RIVER RD APT H95
Second Line :
City : TUCSON
State : AZ
Zip : 85718-5762
Country : US
Telephone Number : 623-451-7420
Fax Number :
Provider Business Practice Location Address
First Line : 5100 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-2114
Country : US
Telephone Number : 520-323-0012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2015
Last Update Date : 09/08/2015

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Directions to “ JEFFREY GOYETTE STEVENS RPH” Practice Location

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