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NPI Code Detail

MEDICARE: TAWNY LIZARRAGA

MEDICARE: TAWNY LIZARRAGA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS017360AZ

General Provider Information

NPI Number : 1033404041
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAWNY LIZARRAGA
Provider Business Mailing Address
First Line : 2140 E BASELINE RD
Second Line : 1905
City : PHOENIX
State : AZ
Zip : 85042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2140 E BASELINE RD
Second Line : 1905
City : PHOENIX
State : AZ
Zip : 85042-6910
Country : US
Telephone Number : 602-281-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2011
Last Update Date : 06/17/2011

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Directions to “ TAWNY LIZARRAGA ” Practice Location

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