MEDICARE: MR. JOHN S HELFRICH R.PH.

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	32260	TX

General Provider Information

NPI Number	:	1437467271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN S HELFRICH R.PH.

Provider Business Mailing Address
First Line	:	13501 PARK VISTA BLVD
Second Line	:	SUITE 150
City	:	FORT WORTH
State	:	TX
Zip	:	76177-3203
Country	:	US
Telephone Number	:	817-837-8606
Fax Number	:

Provider Business Practice Location Address
First Line	:	13501 PARK VISTA BLVD
Second Line	:	SUITE 150
City	:	FORT WORTH
State	:	TX
Zip	:	76177-3203
Country	:	US
Telephone Number	:	817-837-8606
Fax Number	:

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

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	09/15/2010

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