Karen Lee Bloom

Individual provider Active NPI Pharmacist · Tolleson, AZ

NPI 1649498577 · NPPES record last updated Nov 13, 2009

Key facts

NPI
1649498577
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
10608 (AZ)
Practice address
500 S 99TH Ave
Tolleson, AZ 85353-9700
Phone
(623) 907-4938
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10608AZMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10608 AZ Yes

Addresses

Primary practice location

500 S 99TH Ave
Tolleson, AZ 85353-9700

Mailing address

500 S 99TH Ave
Tolleson, AZ 85353-9700
Phone (623) 907-4938

Other providers in Tolleson, AZ

All providers in Tolleson, AZ · Pharmacist in Arizona

Sources for this page

Verify at the official NPI Registry.