MEDICARE: BARBARA JAHN

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	115852	MN

General Provider Information

NPI Number	:	1194011742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA JAHN

Provider Business Mailing Address
First Line	:	1902 MILLER TRUNK HWY
Second Line	:	T-0004
City	:	DULUTH
State	:	MN
Zip	:	55811-1810
Country	:	US
Telephone Number	:	218-727-8475
Fax Number	:	218-727-8475

Provider Business Practice Location Address
First Line	:	1902 MILLER TRUNK HWY
Second Line	:	T-0004
City	:	DULUTH
State	:	MN
Zip	:	55811-1810
Country	:	US
Telephone Number	:	218-727-8475
Fax Number	:	218-727-8475

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

Provider Enumeration Date	:	06/22/2011
Last Update Date	:	06/22/2011

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