=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255025904
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARTEMIS ROSE HUNTSMAN PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2023
-----------------------------------------------------
Last Update Date | 06/06/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2730 STOCKTON BLVD
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95817-2217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-794-0900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 485 TAILOFF LN
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95818-2867
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 260-237-1215
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835S0206X
-----------------------------------------------------
Taxonomy Name | Solid Organ Transplant Pharmacist
-----------------------------------------------------
License Number | 86591
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------