MEDICARE: DR. TRENA DEWBERRY TOCHTROP PHARM D

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	RPH016473	GA

General Provider Information

NPI Number	:	1326019910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRENA DEWBERRY TOCHTROP PHARM D

Provider Business Mailing Address
First Line	:	7394A SALEM DR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-7622
Country	:	US
Telephone Number	:	662-434-8419
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 INDEPENDENCE AVE
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39710-0001
Country	:	US
Telephone Number	:	662-434-1101
Fax Number	:	662-434-2169

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/08/2007

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