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General NPI Number Information
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NPI Number | 1821868308
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Entity Type | Individual
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Provider Name | KELSEY COZZOLINO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 9050 W UNION HILLS DR
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City | PEORIA
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State | AZ
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Zip | 85382-3023
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Country | US
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Telephone | 623-566-1986
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Fax |
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Provider Business Mailing Address
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Address Line | 10621 W ANGELS LN
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City | PEORIA
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State | AZ
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Zip | 85383-1722
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Country | US
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Telephone | 623-313-1252
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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 | S026776
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License Number State | AZ
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