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General NPI Number Information
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NPI Number | 1427666270
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Entity Type | Individual
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Provider Name | GEORGIANA MARIE BOECKMANN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 4006 E BELL RD
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City | PHOENIX
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State | AZ
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Zip | 85032-2232
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Country | US
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Telephone | 602-971-1312
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Fax |
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Provider Business Mailing Address
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Address Line | 17212 N SCOTTSDALE RD APT 1121
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-9601
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Country | US
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Telephone |
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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 | S024503
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License Number State | AZ
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