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NPI Code Detail

MEDICARE: MRS. SUSAN M ALLEN

MEDICARE: MRS. SUSAN M ALLEN
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
1183500000XPharmacistAZS009103AZ

General Provider Information

NPI Number : 1467613851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN M ALLEN
Provider Business Mailing Address
First Line : 9043 W OLIVE AVE
Second Line :
City : PEORIA
State : AZ
Zip : 85345-7049
Country : US
Telephone Number : 623-979-1383
Fax Number :
Provider Business Practice Location Address
First Line : 9043 W OLIVE AVE
Second Line :
City : PEORIA
State : AZ
Zip : 85345-7049
Country : US
Telephone Number : 623-979-1383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/19/2008

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Directions to “ MRS. SUSAN M ALLEN ” Practice Location

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