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General NPI Number Information
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NPI Number | 1669547121
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Entity Type | Individual
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Provider Name | JOHN EDWARD PACEY R. PH.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 3141 N 3RD AVE
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City | PHOENIX
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State | AZ
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Zip | 85013-4351
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Country | US
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Telephone | 602-664-5494
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Fax | 602-664-5466
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Provider Business Mailing Address
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Address Line | 801 E WALTANN LN
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City | PHOENIX
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State | AZ
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Zip | 85022-3507
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Country | US
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Telephone | 602-354-5922
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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 | 03-3-10561
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10246
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S016943
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License Number State | AZ
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