MEDICARE: DR. ANDREW MIZE PHARM.D.

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	PD11643	AR

General Provider Information

NPI Number	:	1891199691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW MIZE PHARM.D.

Provider Business Mailing Address
First Line	:	5403 W PINNACLE POINTE DR
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8118
Country	:	US
Telephone Number	:	479-271-6300
Fax Number	:	479-271-6305

Provider Business Practice Location Address
First Line	:	5403 W PINNACLE POINTE DR
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8118
Country	:	US
Telephone Number	:	479-271-6300
Fax Number	:	479-271-6305

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

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	06/17/2020

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