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General NPI Number Information
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NPI Number | 1548660822
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Entity Type | Individual
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Provider Name | BELLEH TAKU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 3910 E 22ND ST
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City | TUCSON
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State | AZ
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Zip | 85711-5333
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Country | US
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Telephone | 520-745-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 6788 S SONORAN BLOOM AVE
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City | TUCSON
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State | AZ
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Zip | 85756-3040
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Country | US
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Telephone | 520-388-9814
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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 | S020560
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License Number State | AZ
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