MEDICARE: LORI RENE CUTTER

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	S012731	AZ

General Provider Information

NPI Number	:	1053907774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI RENE CUTTER

Provider Business Mailing Address
First Line	:	4973 E DALE LN
Second Line	:
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331-3309
Country	:	US
Telephone Number	:	480-206-9505
Fax Number	:

Provider Business Practice Location Address
First Line	:	731 E UNION HILLS DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-2900
Country	:	US
Telephone Number	:	602-652-9521
Fax Number	:

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

Provider Enumeration Date	:	12/16/2020
Last Update Date	:	12/16/2020

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Directions to “ LORI RENE CUTTER ” Practice Location

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