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NPI Code Detail

MEDICARE: DR. KENNETH J TABOR PHARM. D., BCPS

MEDICARE: DR. KENNETH J TABOR PHARM. D., BCPS
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
11835P1200XPharmacotherapy Pharmacist16762MA

General Provider Information

NPI Number : 1093707507
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH J TABOR PHARM. D., BCPS
Provider Business Mailing Address
First Line : 107 RIDGEVIEW TER
Second Line :
City : WESTFIELD
State : MA
Zip : 01085-2007
Country : US
Telephone Number : 413-572-3761
Fax Number :
Provider Business Practice Location Address
First Line : 725 NORTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-4132
Country : US
Telephone Number : 413-395-7911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 07/08/2007

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