MEDICARE: DR. ANDREA L BARHAM PHARMD

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	37252	TN

General Provider Information

NPI Number	:	1891304127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA L BARHAM PHARMD

Provider Business Mailing Address
First Line	:	4111 OAKSTONE LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1797
Country	:	US
Telephone Number	:	910-512-2972
Fax Number	:

Provider Business Practice Location Address
First Line	:	431 PARK VILLAGE RD STE 105
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3806
Country	:	US
Telephone Number	:	910-512-2972
Fax Number	:

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

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	07/22/2020

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