MEDICARE: LAURA R LATIMER PHARM.D

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	S017217	AZ
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	S017217	AZ

General Provider Information

NPI Number	:	1235464397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA R LATIMER PHARM.D

Provider Business Mailing Address
First Line	:	500 S 99TH AVE
Second Line	:
City	:	TOLLESON
State	:	AZ
Zip	:	85353-9700
Country	:	US
Telephone Number	:	623-907-4938
Fax Number	:	480-988-6303

Provider Business Practice Location Address
First Line	:	5941 E MCKELLIPS RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85215-2754
Country	:	US
Telephone Number	:	480-830-6343
Fax Number	:	480-981-0156

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

Provider Enumeration Date	:	10/07/2009
Last Update Date	:	06/19/2026

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