MEDICARE: DAVID JAMES BARES RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13983	LA

General Provider Information

NPI Number	:	1003808247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID JAMES BARES RPH

Provider Business Mailing Address
First Line	:	102 FERN HOLW
Second Line	:
City	:	YOUNGSVILLE
State	:	LA
Zip	:	70592-5147
Country	:	US
Telephone Number	:	337-857-8703
Fax Number	:	337-856-8382

Provider Business Practice Location Address
First Line	:	202 CHURCH ST
Second Line	:
City	:	YOUNGSVILLE
State	:	LA
Zip	:	70592
Country	:	US
Telephone Number	:	337-856-5761
Fax Number	:	337-856-8382

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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