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General NPI Number Information
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NPI Number | 1588965859
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Entity Type | Individual
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Provider Name | ANTONELLA SOLA
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Gender | Female
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 518 WESTWOOD DR
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City | PRESCOTT
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State | AZ
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Zip | 86303-3436
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Country | US
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Telephone | 928-776-4874
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2221
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City | PRESCOTT
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State | AZ
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Zip | 86302-2221
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Country | US
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Telephone | 928-776-4874
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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 | S011839
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License Number State | AZ
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