Basic Information
| Provider Information | |||||||||
| NPI: | 1942308390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KNUTSON | ||||||||
| FirstName: | FOSTER | ||||||||
| MiddleName: | |||||||||
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| Credential: | MS PHARM, RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 781 W KO VAYA DR | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857043209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208742380 | ||||||||
| FaxNumber: | 5208742314 | ||||||||
| Practice Location | |||||||||
| Address1: | 2800 E AJO WAY | ||||||||
| Address2: | UPH PHARMACY AT KINO CAMPUS | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857136204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208742380 | ||||||||
| FaxNumber: | 5208744312 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 8114 | AZ | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.