MEDICARE: DR. PAUL J OESTERMAN PHARM. D.

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	10109	NV
2	183500000X	Pharmacist	30179	CA

General Provider Information

NPI Number	:	1407885551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL J OESTERMAN PHARM. D.

Provider Business Mailing Address
First Line	:	645 ELLIOTT PEAK AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-7505
Country	:	US
Telephone Number	:	702-361-4805
Fax Number	:

Provider Business Practice Location Address
First Line	:	645 ELLIOTT PEAK AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-7505
Country	:	US
Telephone Number	:	702-361-4805
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/08/2007

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