MEDICARE: JILL ROBIN ALLEN 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
1	183500000X	Pharmacist	S008009	AZ

General Provider Information

NPI Number	:	1497067086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL ROBIN ALLEN RPH

Provider Business Mailing Address
First Line	:	6002 E MAIN ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-8928
Country	:	US
Telephone Number	:	480-985-0155
Fax Number	:	480-396-0497

Provider Business Practice Location Address
First Line	:	6002 E MAIN ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-8928
Country	:	US
Telephone Number	:	480-985-0155
Fax Number	:	480-396-0497

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

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	07/12/2010

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Directions to “ JILL ROBIN ALLEN RPH” Practice Location

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