MEDICARE: MRS. JOANNE BILLINGHURST RPH

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	052332	CA

General Provider Information

NPI Number	:	1689941767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANNE BILLINGHURST RPH

Provider Business Mailing Address
First Line	:	222 BLOSSOM VILLA WAY
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-3911
Country	:	US
Telephone Number	:	408-358-7526
Fax Number	:

Provider Business Practice Location Address
First Line	:	14100 BLOSSOM HILL RD
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-5118
Country	:	US
Telephone Number	:	408-356-1152
Fax Number	:

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

Provider Enumeration Date	:	11/17/2011
Last Update Date	:	11/17/2011

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