MEDICARE: DR. TARIE GRESHAM TODMAN 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	0202206901	VA

General Provider Information

NPI Number	:	1194766519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARIE GRESHAM TODMAN PHARMD

Provider Business Mailing Address
First Line	:	7900 SCULLY CT
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20111-8268
Country	:	US
Telephone Number	:	703-330-8878
Fax Number	:	703-330-8878

Provider Business Practice Location Address
First Line	:	7900 SCULLY CT
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20111
Country	:	US
Telephone Number	:	703-531-7852
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	04/05/2012

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