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General NPI Number Information
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NPI Number | 1063743664
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Entity Type | Individual
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Provider Name | LORRETTA SUE JEWELL
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Gender | Female
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 4700 E BROADWAY BLVD
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City | TUCSON
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State | AZ
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Zip | 85711-3608
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Country | US
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Telephone | 520-327-0045
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Fax | 520-327-5228
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Provider Business Mailing Address
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Address Line | PO BOX 3609
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City | TUCSON
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State | AZ
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Zip | 85722-3609
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Country | US
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Telephone | 520-358-1968
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S006358
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License Number State | AZ
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