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General NPI Number Information
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NPI Number | 1639484538
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Entity Type | Individual
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Provider Name | MATTHEW J CANGEMI PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 925 W BASELINE RD STE 108
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City | TEMPE
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State | AZ
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Zip | 85283-1100
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Country | US
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Telephone | 480-820-1990
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Fax |
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Provider Business Mailing Address
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Address Line | 7606 S 7TH ST
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City | PHOENIX
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State | AZ
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Zip | 85042-6503
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Country | US
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Telephone | 602-243-1525
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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 | S017946
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License Number State | AZ
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