MEDICARE: ARIEL DUNN-EVANCZUK 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	PH1000830	MA
2	183500000X	Pharmacist	033.0135416	VT

General Provider Information

NPI Number	:	1629814918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL DUNN-EVANCZUK PHARMD

Provider Business Mailing Address
First Line	:	55 VETERANS MEMORIAL DR
Second Line	:
City	:	NORTH ADAMS
State	:	MA
Zip	:	01247-2359
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 VETERANS MEMORIAL DR
Second Line	:
City	:	NORTH ADAMS
State	:	MA
Zip	:	01247-2359
Country	:	US
Telephone Number	:	413-664-8712
Fax Number	:

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

Provider Enumeration Date	:	07/05/2024
Last Update Date	:	08/07/2024

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