MEDICARE: BARBARA ANN NEEDHAM 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	3215488	OH
2	183500000X	Pharmacist	5845	SC

General Provider Information

NPI Number	:	1639150295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA ANN NEEDHAM R.PH.

Provider Business Mailing Address
First Line	:	4485 ELECTION HOUSE RD NW
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-8323
Country	:	US
Telephone Number	:	740-756-4056
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 STATE ROUTE 664 N
Second Line	:
City	:	LOGAN
State	:	OH
Zip	:	43138-8541
Country	:	US
Telephone Number	:	740-380-8232
Fax Number	:	740-380-8186

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/08/2007

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