MEDICARE: DR. JOHN F CARGIOLI

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	RP438452	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RP438452	OTHER	PA	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1174516611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN F CARGIOLI

Provider Business Mailing Address
First Line	:	4320 W DESKA DR
Second Line	:	APT 409
City	:	SPOKANE
State	:	WA
Zip	:	99224-2113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 HOSPITAL LOOP
Second Line	:
City	:	FAIRCHILD AFB
State	:	WA
Zip	:	99011-8704
Country	:	US
Telephone Number	:	509-247-3032
Fax Number	:	509-247-2021

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JOHN F CARGIOLI ” Practice Location

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