MEDICARE: MR. ATUL J AMIN

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
1	183500000X	Pharmacist	8929	AZ

General Provider Information

NPI Number	:	1043526817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ATUL J AMIN

Provider Business Mailing Address
First Line	:	PO BOX 546
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85323
Country	:	US
Telephone Number	:	623-925-0701
Fax Number	:

Provider Business Practice Location Address
First Line	:	5102 W INDIAN SCHOOL RD (WALGREENS)
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85031
Country	:	US
Telephone Number	:	623-247-1012
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2010
Last Update Date	:	08/31/2010

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