=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194139360
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. MICHAEL EDWARD BARNHILL
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2014
-----------------------------------------------------
Last Update Date | 06/16/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 E FRANKLIN ST
-----------------------------------------------------
City | FARMERVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71241-2909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-368-8340
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 413 PARK BAY DR
-----------------------------------------------------
City | FARMERVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71241-3708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-348-7608
-----------------------------------------------------
Fax | 866-742-8273
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 015609
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------