Provider Demographics
NPI:1639184054
Name:YAMPOLSKY, THERESA ESCUDERO (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:ESCUDERO
Last Name:YAMPOLSKY
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3748 E LIZARD ROCK PL
Mailing Address - Street 2:3900 E. ALVERNON CIRCLE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2327
Mailing Address - Country:US
Mailing Address - Phone:520-529-1326
Mailing Address - Fax:
Practice Address - Street 1:6360 E GOLF LINKS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1058
Practice Address - Country:US
Practice Address - Phone:520-514-9567
Practice Address - Fax:520-514-9584
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist