MEDICARE: MS. LORRI KRISTEN CAUM RPH

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	S12685	AZ

General Provider Information

NPI Number	:	1063742310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORRI KRISTEN CAUM RPH

Provider Business Mailing Address
First Line	:	2075 W PINNACLE PEAK RD STE 130
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-1218
Country	:	US
Telephone Number	:	602-214-6618
Fax Number	:	623-215-0423

Provider Business Practice Location Address
First Line	:	2075 W PINNACLE PEAK RD STE 130
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-1218
Country	:	US
Telephone Number	:	602-214-6618
Fax Number	:	623-215-0423

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

Provider Enumeration Date	:	01/09/2010
Last Update Date	:	01/09/2010

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