MEDICARE: MICHAEL YARWORTH

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	1835P1200X	Pharmacotherapy Pharmacist	4334	TN

General Provider Information

NPI Number	:	1336219302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL YARWORTH

Provider Business Mailing Address
First Line	:	740 MAIN ST
Second Line	:
City	:	TRACY CITY
State	:	TN
Zip	:	37387-4020
Country	:	US
Telephone Number	:	931-592-9190
Fax Number	:	931-592-9203

Provider Business Practice Location Address
First Line	:	740 MAIN ST
Second Line	:
City	:	TRACY CITY
State	:	TN
Zip	:	37387-4020
Country	:	US
Telephone Number	:	931-592-9190
Fax Number	:	931-592-9203

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	05/14/2013

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