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NPI Code Detail

MEDICARE: TAMME BOOTH RPH

MEDICARE: TAMME BOOTH 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
1183500000XPharmacist45043CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
136453OTHERTXPHARMACIST LICENSE
20202207233OTHERVAPHARMACIST LICENSE
314656OTHERAZPHARMACIST LICENSE
445043OTHERCAPHARMACIST LICENSE
514178OTHERLAPHARMACIST LICENSE

General Provider Information

NPI Number : 1134332562
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMME BOOTH RPH
Provider Business Mailing Address
First Line : 9826 BLUE LAKE DR
Second Line :
City : FOLSOM
State : CA
Zip : 95630-1938
Country : US
Telephone Number : 916-208-6075
Fax Number :
Provider Business Practice Location Address
First Line : 1850 PRAIRIE CITY RD
Second Line :
City : FOLSOM
State : CA
Zip : 95630-9518
Country : US
Telephone Number : 916-608-2455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 07/08/2007

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Directions to “ TAMME BOOTH RPH” Practice Location

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