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General NPI Number Information
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NPI Number | 1205131158
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Entity Type | Individual
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Provider Name | LANCE C. GOOD RPH
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Gender | Male
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 3920 E GRANT RD
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City | TUCSON
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State | AZ
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Zip | 85712-2558
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Country | US
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Telephone | 520-323-2695
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 69944
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City | ORO VALLEY
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State | AZ
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Zip | 85737
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Country | US
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Telephone | 620-272-5057
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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 | S009981
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License Number State | AZ
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