MEDICARE: JAMES BELLAMY 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	183500000X	Pharmacist	RP0004918	WV
2	183500000X	Pharmacist	042774	MO
3	183500000X	Pharmacist	0202205903	VA

General Provider Information

NPI Number	:	1518312370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BELLAMY PHARMACIST

Provider Business Mailing Address
First Line	:	521 JESSE JAMES DR
Second Line	:
City	:	ROCK
State	:	WV
Zip	:	24747-9779
Country	:	US
Telephone Number	:	304-467-8433
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 JESSE JAMES DR
Second Line	:
City	:	ROCK
State	:	WV
Zip	:	24747-9779
Country	:	US
Telephone Number	:	304-467-8433
Fax Number	:

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

Provider Enumeration Date	:	04/29/2016
Last Update Date	:	04/29/2016

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