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NPI Code Detail

MEDICARE: DR. JOE ESTRADA JR. PHARM.D.

MEDICARE: DR. JOE ESTRADA JR. 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
1183500000XPharmacist15551AZ

General Provider Information

NPI Number : 1912237165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOE ESTRADA JR. PHARM.D.
Provider Business Mailing Address
First Line : 3450 W DUNLAP AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-5302
Country : US
Telephone Number : 602-973-0971
Fax Number : 602-973-8204
Provider Business Practice Location Address
First Line : 3450 W DUNLAP AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-5302
Country : US
Telephone Number : 602-973-0971
Fax Number : 602-973-8204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2010
Last Update Date : 01/11/2010

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