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NPI Code Detail

MEDICARE: WILMOT CENTER PHARMACY

MEDICARE: WILMOT CENTER PHARMACY
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
13336C0003XCommunity/Retail PharmacyY005104AZ

General Provider Information

NPI Number : 1124267919
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILMOT CENTER PHARMACY
Provider Business Mailing Address
First Line : 6369 E TANQUE VERDE RD STE 100
Second Line :
City : TUCSON
State : AZ
Zip : 85715-3833
Country : US
Telephone Number : 520-721-3088
Fax Number :
Provider Business Practice Location Address
First Line : 6369 E TANQUE VERDE RD STE 100
Second Line :
City : TUCSON
State : AZ
Zip : 85715-3833
Country : US
Telephone Number : 520-721-3088
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. JOEL D RHOADS
Credential :
Telephone Number : 520-721-3088
Provider Enumeration Date : 02/18/2009
Last Update Date : 02/18/2009

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Directions to “WILMOT CENTER PHARMACY ” Practice Location

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