MEDICARE: EMILY LAWRENCE

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	S009589	AZ
2	183500000X	Pharmacist	151493-1701	MI

General Provider Information

NPI Number	:	1629497003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY LAWRENCE

Provider Business Mailing Address
First Line	:	7434 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3138
Country	:	US
Telephone Number	:	623-846-5065
Fax Number	:	623-846-9155

Provider Business Practice Location Address
First Line	:	7434 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3138
Country	:	US
Telephone Number	:	623-846-5065
Fax Number	:	623-846-9155

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

Provider Enumeration Date	:	04/14/2014
Last Update Date	:	04/14/2014

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Directions to “ EMILY LAWRENCE ” Practice Location

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