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NPI Code Detail

MEDICARE: DEBRA DIANE STALKER PHARMACIST

MEDICARE: DEBRA DIANE STALKER 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
1183500000XPharmacist11907AZ

General Provider Information

NPI Number : 1942609888
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA DIANE STALKER PHARMACIST
Provider Business Mailing Address
First Line : 16832 S 12TH WAY
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-4755
Country : US
Telephone Number : 480-283-0960
Fax Number :
Provider Business Practice Location Address
First Line : 4430 E RAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-6092
Country : US
Telephone Number : 480-785-1006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2014
Last Update Date : 08/16/2014

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Directions to “ DEBRA DIANE STALKER PHARMACIST” Practice Location

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