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General NPI Number Information
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NPI Number | 1356898340
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Entity Type | Individual
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Provider Name | MARY OLSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 5421 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-4751
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Country | US
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Telephone | 602-547-9645
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Fax |
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Provider Business Mailing Address
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Address Line | 14317 W ARZON WAY
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-2886
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Country | US
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Telephone | 707-235-3329
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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 | S021760
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 47884
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-11980
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License Number State | KS
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