MEDICARE: MR. MATTHEW R STUMPF 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	S013287	AZ

General Provider Information

NPI Number	:	1326378555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW R STUMPF PHARMD

Provider Business Mailing Address
First Line	:	15385 N DYSART RD
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335-9761
Country	:	US
Telephone Number	:	623-583-8248
Fax Number	:

Provider Business Practice Location Address
First Line	:	15385 N DYSART RD
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335-9761
Country	:	US
Telephone Number	:	623-583-8248
Fax Number	:	623-583-8370

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

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	01/11/2010

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