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NPI Code Detail

MEDICARE: DR. JEFFREY BAE PHARM.D

MEDICARE: DR. JEFFREY BAE PHARM.D
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
1183500000XPharmacistS014956AZ

General Provider Information

NPI Number : 1487920468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY BAE PHARM.D
Provider Business Mailing Address
First Line : 32351 N SCOTTSDALE RD
Second Line : T-1327
City : SCOTTSDALE
State : AZ
Zip : 85266-1513
Country : US
Telephone Number : 480-575-5910
Fax Number :
Provider Business Practice Location Address
First Line : 32351 N SCOTTSDALE RD
Second Line : T-1327
City : SCOTTSDALE
State : AZ
Zip : 85266-1513
Country : US
Telephone Number : 480-575-5910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2012
Last Update Date : 03/24/2012

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