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Individual

MRS. LUCY ANN FUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.PH.

Contact information

Practice address
1400 MEDICAL PKWY, CARSON CITY, NV 89703-4624
(520) 300-1532
(775) 883-8905
Mailing address
3410 N CAMINO DE OESTE, TUCSON, AZ 85745-9050
(520) 300-1532

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0110
GU
183500000X
Pharmacist
16334
NV
183500000X
Pharmacist
30523
CA
183500000X
Pharmacist
Primary
6364
AZ

Other

Enumeration date
08/03/2006
Last updated
04/01/2013
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