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General NPI Number Information
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NPI Number | 1740952993
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Entity Type | Organization
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Legal Business Name | TCLSJM, LLC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 10900 N SCOTTSDALE RD STE 401
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-5232
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Country | US
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Telephone | 480-550-9517
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Fax | 888-520-0254
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Provider Business Mailing Address
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Address Line | 10900 N SCOTTSDALE RD STE 401
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-5232
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Country | US
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Telephone | 480-550-9517
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Fax | 888-520-0254
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | SARAH SIMMERS
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Credential | PHARMD
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Telephone | 480-286-3746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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