MEDICARE: AMY LAGESSE 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	S016091	AZ

General Provider Information

NPI Number	:	1770813834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LAGESSE PHARMD

Provider Business Mailing Address
First Line	:	2140 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6910
Country	:	US
Telephone Number	:	602-281-1120
Fax Number	:	602-282-0754

Provider Business Practice Location Address
First Line	:	2140 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6910
Country	:	US
Telephone Number	:	602-281-1120
Fax Number	:	602-282-0754

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

Provider Enumeration Date	:	01/12/2010
Last Update Date	:	05/29/2020

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Directions to “ AMY LAGESSE PHARMD” Practice Location

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