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NPI Code Detail

MEDICARE: MR. PAUL BOOTH RPH

MEDICARE: MR. PAUL 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
1183500000XPharmacist47778CA

General Provider Information

NPI Number : 1326140229
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL 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 : 916-834-0867
Fax Number : 916-726-1065
Provider Business Practice Location Address
First Line : 500 W CAPITOL AVE
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95605-2624
Country : US
Telephone Number : 916-722-1755
Fax Number : 916-726-1065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2006
Last Update Date : 07/08/2007

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