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General NPI Number Information
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NPI Number | 1982663852
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Entity Type | Individual
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Provider Name | WALTER THOMAS GARDIPEE PHARMD, JD, MBA
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 650 EAST INDIAN SCHOOL RD
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City | PHOENIX
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State | AZ
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Zip | 85012-1492
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Country | US
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Telephone | 602-277-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 7426 E BEAVER VALLEY RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-1402
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Country | US
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Telephone | 402-980-9878
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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 | PH-4331
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License Number State | HI
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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 | 12281
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License Number State | NE
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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 | 14110
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License Number State | AZ
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