Peter Orzech, S12854
Individual provider Active NPI Pharmacist · Willcox, AZ
NPI 1790085017 · NPPES record last updated Nov 2, 2010
Key facts
- NPI
- 1790085017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S12854 (AZ)
- Practice address
- 650 N Bisbee Ave
Willcox, AZ 85643-1437 - Phone
- (520) 384-4612
- NPI assigned
- Nov 2, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S12854 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S12854 | AZ | Yes |
Addresses
Primary practice location
650 N Bisbee Ave
Willcox, AZ 85643-1437
Mailing address
650 N Bisbee Ave
Willcox, AZ 85643-1437
Phone (520) 384-4612
Other providers in Willcox, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.