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NPI Code Detail

MEDICARE: ANTHONY J GUIDO RPH

MEDICARE:   ANTHONY J GUIDO  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
1183500000XPharmacist26018488AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
126018488AOTHERINSTATE PHARMACY LICENSE

General Provider Information

NPI Number : 1861043986
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY J GUIDO RPH
Provider Business Mailing Address
First Line : 5340 E 800 S
Second Line :
City : COLUMBIA CITY
State : IN
Zip : 46725-9248
Country : US
Telephone Number : 260-433-4066
Fax Number :
Provider Business Practice Location Address
First Line : 1710 APPLE GLEN BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1725
Country : US
Telephone Number : 260-432-9330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2019
Last Update Date : 09/20/2019

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