MEDICARE: MS. SUSAN E BARTLEMAY R.PH.

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	18311	TX

General Provider Information

NPI Number	:	1437351756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN E BARTLEMAY R.PH.

Provider Business Mailing Address
First Line	:	400 HAMPTON DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-3630
Country	:	US
Telephone Number	:	972-207-4922
Fax Number	:	469-519-0343

Provider Business Practice Location Address
First Line	:	8282 PARK LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-6023
Country	:	US
Telephone Number	:	214-987-0452
Fax Number	:	214-346-0401

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	11/09/2012

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