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NPI Code Detail

MEDICARE: JAMES C BAWDEN RPH

MEDICARE:   JAMES C BAWDEN  RPH
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
1183500000XPharmacist144796UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1144796OTHERUTDOPL LICENSE NUMBER

General Provider Information

NPI Number : 1194000901
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES C BAWDEN RPH
Provider Business Mailing Address
First Line : 4586 N 50 W
Second Line :
City : PROVO
State : UT
Zip : 84604-5506
Country : US
Telephone Number : 801-367-2086
Fax Number : 801-235-1774
Provider Business Practice Location Address
First Line : 1315 N STATE ST
Second Line :
City : PROVO
State : UT
Zip : 84604-2416
Country : US
Telephone Number : 801-616-5223
Fax Number : 801-616-5252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2011
Last Update Date : 10/13/2011

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