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NPI Code Detail

MEDICARE: CHRISTINE LY PHARMD

MEDICARE: CHRISTINE LY 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
1183500000XPharmacistS022799AZ

General Provider Information

NPI Number : 1326557273
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE LY PHARMD
Provider Business Mailing Address
First Line : 6975 E PRINCESS DR APT 2026
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-4218
Country : US
Telephone Number : 408-890-0587
Fax Number :
Provider Business Practice Location Address
First Line : 5011 W UNION HILLS DR
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-1441
Country : US
Telephone Number : 602-896-0257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2017
Last Update Date : 09/22/2017

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Directions to “ CHRISTINE LY PHARMD” Practice Location

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