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WILLIAM THOMAS PARK

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1750572251

Individual Registrant:
 WILLIAM THOMAS PARK 
Gender: M
Sole Proprietor

Location and contact information for practice:
101 CIBEQUE CIRCLE  SAN CARLOS, AZ 85550 US
Tel: 520-475-7272  Fax: --

Contact information for business:
10497 E TORTILLA CREEK CT  GOLD CANYON, AZ 85218-5107 US
Tel: 256-652-8985  Fax: --

Registration Information:
NPI: 1750572251
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
AL14443

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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