MEDICARE: KATHRYN WULBRECHT

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	S008934	AZ

General Provider Information

NPI Number	:	1366772550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN WULBRECHT

Provider Business Mailing Address
First Line	:	10865 N TATUM BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3055
Country	:	US
Telephone Number	:	480-922-2725
Fax Number	:

Provider Business Practice Location Address
First Line	:	10865 N TATUM BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3055
Country	:	US
Telephone Number	:	480-922-2725
Fax Number	:	480-922-2118

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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Directions to “ KATHRYN WULBRECHT ” Practice Location

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