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NPI Code Detail

MEDICARE: SUSAN MATHIAS PHARMACIST

MEDICARE: SUSAN MATHIAS PHARMACIST
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
1183500000XPharmacistS011084AZ

General Provider Information

NPI Number : 1851170062
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MATHIAS PHARMACIST
Provider Business Mailing Address
First Line : 7236 S CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85042-5425
Country : US
Telephone Number : 602-243-7266
Fax Number :
Provider Business Practice Location Address
First Line : 7236 S CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85042-5425
Country : US
Telephone Number : 602-243-7266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2023
Last Update Date : 09/29/2023

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Directions to “ SUSAN MATHIAS PHARMACIST” Practice Location

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