=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528156262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY N GOETZ PHARM.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2006
-----------------------------------------------------
Last Update Date | 06/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3901 W INA RD
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85741-2206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-918-3602
-----------------------------------------------------
Fax | 520-918-3602
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3711 N BANNER MINE DR
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85745-4106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-918-3602
-----------------------------------------------------
Fax | 520-918-3602
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 15658
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------