MEDICARE: STEPHANIE ROSE LOPEZ PHARMD, 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	S019226	AZ

General Provider Information

NPI Number	:	1649527656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ROSE LOPEZ PHARMD, RPH

Provider Business Mailing Address
First Line	:	8980 E TANQUE VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9604
Country	:	US
Telephone Number	:	520-749-0205
Fax Number	:

Provider Business Practice Location Address
First Line	:	8980 E TANQUE VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9604
Country	:	US
Telephone Number	:	520-749-0205
Fax Number	:

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

Provider Enumeration Date	:	08/08/2012
Last Update Date	:	04/29/2014

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