MEDICARE: DR. PAUL H FIRTH

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	32973	TN
2	183500000X	Pharmacist	15931	AL
3	183500000X	Pharmacist	RPH024214	GA

General Provider Information

NPI Number	:	1356652333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL H FIRTH

Provider Business Mailing Address
First Line	:	6827 VILLAGE LAKE CIR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37412-4095
Country	:	US
Telephone Number	:	706-264-0707
Fax Number	:

Provider Business Practice Location Address
First Line	:	3625 BATTLEFIELD PKWY
Second Line	:
City	:	FT OGLETHORPE
State	:	GA
Zip	:	30742-4001
Country	:	US
Telephone Number	:	706-866-1839
Fax Number	:

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

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	06/24/2010

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