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NPI Code Detail

MEDICARE: MR. FABIAN VASQUEZ RPH

MEDICARE: MR. FABIAN VASQUEZ 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
1183500000XPharmacist046079-1NY
2183500000XPharmacist28RI02853500NJ
3183500000XPharmacistPS33709FL

General Provider Information

NPI Number : 1407031917
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FABIAN VASQUEZ RPH
Provider Business Mailing Address
First Line : 30 HUNTER LN
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-2400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30 HUNTER LN
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-2400
Country : US
Telephone Number : 717-761-2633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 02/04/2014

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