MEDICARE: DR. FRANK M BERTONE PHARMD

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	S018596	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S018596	OTHER	AZ	ARIZONA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1144504879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK M BERTONE PHARMD

Provider Business Mailing Address
First Line	:	7759 W TIGHT LINE DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85757-1618
Country	:	US
Telephone Number	:	573-356-0694
Fax Number	:

Provider Business Practice Location Address
First Line	:	7759 W TIGHT LINE DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85757-1618
Country	:	US
Telephone Number	:	573-356-0694
Fax Number	:

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

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	09/29/2011

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