MEDICARE: DR. EDWARD VERNON NARBUTH 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	S12029	AZ

General Provider Information

NPI Number	:	1083633085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD VERNON NARBUTH PHARMD

Provider Business Mailing Address
First Line	:	3003 HUALAPAI MOUNTAIN RD LOT 30
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86401-5391
Country	:	US
Telephone Number	:	928-753-3508
Fax Number	:

Provider Business Practice Location Address
First Line	:	3269 STOCKTON HILL RD
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3619
Country	:	US
Telephone Number	:	928-757-0618
Fax Number	:	928-692-4141

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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