MEDICARE: DR. JAMES DAVID ARTH 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	2011020687	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2011020687	OTHER	MO	MISSOURI BOARD OF PHARMACY

General Provider Information

NPI Number	:	1023393626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DAVID ARTH PHARMD

Provider Business Mailing Address
First Line	:	803 E GREEN MEADOWS RD APT 103
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3724
Country	:	US
Telephone Number	:	417-372-2841
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 MISSOURI BLVD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-4717
Country	:	US
Telephone Number	:	573-636-7924
Fax Number	:	573-634-6046

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

Provider Enumeration Date	:	10/14/2011
Last Update Date	:	10/14/2011

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