MEDICARE: TAYLOR BOTELHO PHARMD, RPH

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	PH240632	MA

General Provider Information

NPI Number	:	1376295279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR BOTELHO PHARMD, RPH

Provider Business Mailing Address
First Line	:	58 APPLE CREEK LN
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-4754
Country	:	US
Telephone Number	:	508-493-8320
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 APPLE CREEK LN
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-4754
Country	:	US
Telephone Number	:	508-493-8320
Fax Number	:

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

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	01/21/2022

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