MEDICARE: MR. DAVID H. TUTTLE B.S. 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	15408	MA

General Provider Information

NPI Number	:	1184950594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID H. TUTTLE B.S. R. PH.

Provider Business Mailing Address
First Line	:	18 MAPLE AVE.
Second Line	:	P.O. BOX 233
City	:	RUTLAND
State	:	MA
Zip	:	01543-0233
Country	:	US
Telephone Number	:	508-886-6261
Fax Number	:	508-886-2443

Provider Business Practice Location Address
First Line	:	18 MAPLE AVE.
Second Line	:
City	:	RUTLAND
State	:	MA
Zip	:	01543-0233
Country	:	US
Telephone Number	:	508-886-6261
Fax Number	:	508-886-2443

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

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	10/29/2009

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