MEDICARE: ANTONIA HO TARARA 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	PH25524	MA

General Provider Information

NPI Number	:	1689957078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIA HO TARARA PHARM.D

Provider Business Mailing Address
First Line	:	585 WASHINGTON ST
Second Line	:
City	:	DORCHESTER CENTER
State	:	MA
Zip	:	02124-2032
Country	:	US
Telephone Number	:	617-825-2401
Fax Number	:	617-825-3425

Provider Business Practice Location Address
First Line	:	585 WASHINGTON ST
Second Line	:
City	:	DORCHESTER CENTER
State	:	MA
Zip	:	02124-2032
Country	:	US
Telephone Number	:	617-825-2401
Fax Number	:	617-825-3425

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

Provider Enumeration Date	:	09/22/2011
Last Update Date	:	09/22/2011

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