MEDICARE: TRAZI AUGUST BAKER 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	26019106A	IN

General Provider Information

NPI Number	:	1376368720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAZI AUGUST BAKER RPH

Provider Business Mailing Address
First Line	:	1722 W 600 S
Second Line	:
City	:	NEW PALESTINE
State	:	IN
Zip	:	46163-9585
Country	:	US
Telephone Number	:	317-410-2635
Fax Number	:

Provider Business Practice Location Address
First Line	:	4545 LAFAYETTE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-2033
Country	:	US
Telephone Number	:	317-328-0325
Fax Number	:

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

Provider Enumeration Date	:	11/20/2024
Last Update Date	:	11/20/2024

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