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General NPI Number Information
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NPI Number | 1124267919
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Entity Type | Organization
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Legal Business Name | WILMOT CENTER PHARMACY
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 6369 E TANQUE VERDE RD STE 100
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City | TUCSON
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State | AZ
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Zip | 85715-3833
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Country | US
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Telephone | 520-721-3088
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Fax |
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Provider Business Mailing Address
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Address Line | 6369 E TANQUE VERDE RD STE 100
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City | TUCSON
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State | AZ
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Zip | 85715-3833
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Country | US
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Telephone | 520-721-3088
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOEL D RHOADS
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Credential |
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Telephone | 520-721-3088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y005104
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License Number State | AZ
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