MEDICARE: MRS. WHITNEY DENISE ARB 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	39827	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	39827	OTHER	TX	PHARMACIST LICENSE
2	044453	OTHER	MO	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1063558765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WHITNEY DENISE ARB RPH

Provider Business Mailing Address
First Line	:	5437 CRATER LAKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-4452
Country	:	US
Telephone Number	:	817-428-0518
Fax Number	:

Provider Business Practice Location Address
First Line	:	15001 TRINITY BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-2647
Country	:	US
Telephone Number	:	800-455-8352
Fax Number	:

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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