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NPI Code Detail

MEDICARE: DR. JOVENCIO DOMINGO PHARMD

MEDICARE:  DR. JOVENCIO  DOMINGO  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
1183500000XPharmacistS013244AZ
2183500000XPharmacist10747OR

General Provider Information

NPI Number : 1922387869
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOVENCIO DOMINGO PHARMD
Provider Business Mailing Address
First Line : 1118 E TAPATIO DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-1187
Country : US
Telephone Number : 602-369-0577
Fax Number :
Provider Business Practice Location Address
First Line : 8245 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85033-4722
Country : US
Telephone Number : 623-849-1940
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2011
Last Update Date : 02/21/2017

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Directions to “ DR. JOVENCIO DOMINGO PHARMD” Practice Location

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