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General NPI Number Information
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NPI Number | 1427263417
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Entity Type | Individual
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Provider Name | CARL F WILKE R.PH.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9003 E SHEA BLVD PHARMACY
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6709
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Country | US
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Telephone | 480-323-3850
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Fax |
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Provider Business Mailing Address
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Address Line | 9210 N 106TH WAY
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-6110
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Country | US
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Telephone | 480-614-3194
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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 | 10369
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License Number State | AZ
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