MEDICARE: JOHN WILLIAM FOSTER

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	RP028026L	PA

General Provider Information

NPI Number	:	1255620043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WILLIAM FOSTER

Provider Business Mailing Address
First Line	:	278 WASHINGTON ST
Second Line	:
City	:	DUNCANSVILLE
State	:	PA
Zip	:	16635-8119
Country	:	US
Telephone Number	:	814-696-3382
Fax Number	:	814-696-3382

Provider Business Practice Location Address
First Line	:	3331 PLEASANT VALLEY BLVD
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-4311
Country	:	US
Telephone Number	:	814-942-1081
Fax Number	:	814-942-6049

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

Provider Enumeration Date	:	04/01/2011
Last Update Date	:	04/01/2011

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