MEDICARE: BARRY ALAN BATES 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	9387	TN

General Provider Information

NPI Number	:	1699813949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY ALAN BATES RPH

Provider Business Mailing Address
First Line	:	615 PINE BROW TRL
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-4597
Country	:	US
Telephone Number	:	423-899-6476
Fax Number	:

Provider Business Practice Location Address
First Line	:	4632 HIGHWAY 58
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37416-3013
Country	:	US
Telephone Number	:	423-894-3223
Fax Number	:

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	07/08/2007

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