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General NPI Number Information
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NPI Number | 1841776069
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Entity Type | Individual
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Provider Name | NATASHA SAVINA NORONHA
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Gender | Female
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 501 BELT LINE RD
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City | COLLINSVILLE
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State | IL
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Zip | 62234-4410
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Country | US
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Telephone | 618-345-7811
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Fax | 618-345-7812
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Provider Business Mailing Address
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Address Line | 4902 SMITH DR
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-5806
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Country | US
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Telephone | 734-502-1895
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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 | 051.291700
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License Number State | IL
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