MEDICARE: MR. ADAM COLBY WHITESCARVER 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	S010664	AZ

General Provider Information

NPI Number	:	1265740633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADAM COLBY WHITESCARVER RPH

Provider Business Mailing Address
First Line	:	1835 E GUADALUPE RD
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-3277
Country	:	US
Telephone Number	:	480-838-0448
Fax Number	:	480-730-9860

Provider Business Practice Location Address
First Line	:	1835 E GUADALUPE RD
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-3277
Country	:	US
Telephone Number	:	480-838-0448
Fax Number	:	480-730-9860

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

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	03/24/2017

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