MEDICARE: PATRICK TU 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	RPH027232	GA
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH027232	GA

General Provider Information

NPI Number	:	1497176424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK TU PHARM.D

Provider Business Mailing Address
First Line	:	3360 COMMONS GATE BND
Second Line	:
City	:	BERKELEY LAKE
State	:	GA
Zip	:	30092-4969
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 W BELMONT DR
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-3064
Country	:	US
Telephone Number	:	706-625-4211
Fax Number	:

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

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	01/30/2020

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