Healthcare Provider Details

I. General information

NPI: 1346224524
Provider Name (Legal Business Name): JILL MARNI SCHULTZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N CAMPBELL AVE
TUCSON AZ
85724-0001
US

IV. Provider business mailing address

5751 N. KOLB RD APARTMENT 5207
TUCSON AZ
85750
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-2484
  • Fax:
Mailing address:
  • Phone: 925-286-8359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number15112
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number57292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: