MEDICARE: ASHLEY COLYER 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
1	183500000X	Pharmacist	S018660	AZ

General Provider Information

NPI Number	:	1487934329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY COLYER PHARMD

Provider Business Mailing Address
First Line	:	7901 N CORTARO RD APT 19202
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-7870
Country	:	US
Telephone Number	:	307-330-7419
Fax Number	:

Provider Business Practice Location Address
First Line	:	4748 E SUNRISE DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4535
Country	:	US
Telephone Number	:	520-577-1044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2011
Last Update Date	:	08/24/2011

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