Healthcare Provider Details

I. General information

NPI: 1285114330
Provider Name (Legal Business Name): ERIN RZECZKOWSKI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6644 E BAYWOOD AVE
MESA AZ
85206-1747
US

IV. Provider business mailing address

1736 N SIERRA VISTA DR
TEMPE AZ
85281-1434
US

V. Phone/Fax

Practice location:
  • Phone: 480-321-4261
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS020933
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: