MEDICARE: DR. ROTARCHA E HARDAWAY PHARMD

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	0000011936	TN

General Provider Information

NPI Number	:	1437380433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROTARCHA E HARDAWAY PHARMD

Provider Business Mailing Address
First Line	:	346 CHICKASAW LAND CV
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-3389
Country	:	US
Telephone Number	:	901-644-0852
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 AUSTIN PEAY HWY
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38128-4634
Country	:	US
Telephone Number	:	901-372-7277
Fax Number	:	901-387-0480

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

Provider Enumeration Date	:	08/07/2009
Last Update Date	:	08/07/2009

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