MEDICARE: DR. TARA N KESH 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	RP441010	PA

General Provider Information

NPI Number	:	1255595872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA N KESH PHARMD

Provider Business Mailing Address
First Line	:	15 S MAIN ST
Second Line	:
City	:	SHENANDOAH
State	:	PA
Zip	:	17976-2332
Country	:	US
Telephone Number	:	570-462-1924
Fax Number	:	570-462-1760

Provider Business Practice Location Address
First Line	:	15 S MAIN ST
Second Line	:
City	:	SHENANDOAH
State	:	PA
Zip	:	17976-2332
Country	:	US
Telephone Number	:	570-462-1924
Fax Number	:	570-462-1760

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

Provider Enumeration Date	:	07/13/2008
Last Update Date	:	07/16/2014

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