MEDICARE: JAMES DUNAWAY 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	7646	KY

General Provider Information

NPI Number	:	1063524379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DUNAWAY R.PH.

Provider Business Mailing Address
First Line	:	13023 CRESTWOOD CT
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-9108
Country	:	US
Telephone Number	:	270-826-0337
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 3RD ST
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-2993
Country	:	US
Telephone Number	:	270-826-6565
Fax Number	:	270-830-0083

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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