MEDICARE: DR. DIANA TSAI 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
1	183500000X	Pharmacist	PR12977	ME

General Provider Information

NPI Number	:	1619387750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA TSAI PHARM.D.

Provider Business Mailing Address
First Line	:	868 MAIN ST
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-3530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	868 MAIN ST
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-3530
Country	:	US
Telephone Number	:	207-490-4008
Fax Number	:

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

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	04/29/2014

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