MEDICARE: DENISE A BARTER RPH MBA

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	PS19705	FL
2	183500000X	Pharmacist	PU2543	FL

General Provider Information

NPI Number	:	1396731022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE A BARTER RPH MBA

Provider Business Mailing Address
First Line	:	708 SATINLEAF AVE
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-4516
Country	:	US
Telephone Number	:	813-855-9089
Fax Number	:	813-855-9089

Provider Business Practice Location Address
First Line	:	708 SATINLEAF AVE
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-4516
Country	:	US
Telephone Number	:	813-855-9089
Fax Number	:	813-855-9089

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	07/08/2007

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