MEDICARE: GARY R BAUMAN BSPHARM, 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	03-3-12893	OH

General Provider Information

NPI Number	:	1659576585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY R BAUMAN BSPHARM, R.PH.

Provider Business Mailing Address
First Line	:	1761 N CLEVELAND MASSILLON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-1860
Country	:	US
Telephone Number	:	330-665-2317
Fax Number	:	330-665-2274

Provider Business Practice Location Address
First Line	:	1761 N CLEVELAND MASSILLON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-1860
Country	:	US
Telephone Number	:	330-665-2317
Fax Number	:	330-665-2274

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/08/2007

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