MEDICARE: DR. TAMARA JOHNSON PHARM.D.

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	15790	NV

General Provider Information

NPI Number	:	1487778064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMARA JOHNSON PHARM.D.

Provider Business Mailing Address
First Line	:	18107 CHERRYLEAF CT
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89506-5052
Country	:	US
Telephone Number	:	775-674-1544
Fax Number	:

Provider Business Practice Location Address
First Line	:	5485 SUN VALLEY BLVD
Second Line	:
City	:	SUN VALLEY
State	:	NV
Zip	:	89433-7633
Country	:	US
Telephone Number	:	775-674-1544
Fax Number	:

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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