MEDICARE: MR. JOE D. NEWTON REGISTER PHARMACIST

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	1835P1200X	Pharmacotherapy Pharmacist	3550	SC

General Provider Information

NPI Number	:	1376691006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOE D. NEWTON REGISTER PHARMACIST

Provider Business Mailing Address
First Line	:	253 FOREST TRL
Second Line	:
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-2519
Country	:	US
Telephone Number	:	843-886-8470
Fax Number	:	843-876-0263

Provider Business Practice Location Address
First Line	:	253 FOREST TRL
Second Line	:
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-2519
Country	:	US
Telephone Number	:	843-886-8470
Fax Number	:	843-876-0263

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

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

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