MEDICARE: MRS. SANDRA ELLEN FINN 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	S016033	AZ

General Provider Information

NPI Number	:	1720329337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA ELLEN FINN RPH

Provider Business Mailing Address
First Line	:	3039 E ORIOLE DR
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-8157
Country	:	US
Telephone Number	:	480-626-0592
Fax Number	:

Provider Business Practice Location Address
First Line	:	3039 E ORIOLE DR
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-8157
Country	:	US
Telephone Number	:	480-626-0592
Fax Number	:

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

Provider Enumeration Date	:	03/06/2013
Last Update Date	:	03/06/2013

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