MEDICARE: ALYSSA BARTLETT 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	RP0009232	WV
2	183500000X	Pharmacist	23140	MD

General Provider Information

NPI Number	:	1497130991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA BARTLETT PHARM.D

Provider Business Mailing Address
First Line	:	8 GAYLE DR
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-6300
Country	:	US
Telephone Number	:	304-258-4955
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 GAYLE DR
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-6300
Country	:	US
Telephone Number	:	304-258-4955
Fax Number	:

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

Provider Enumeration Date	:	07/25/2015
Last Update Date	:	07/25/2015

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