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NPI Code Detail

MEDICARE: MR. JOHN GLENN BARCELON

MEDICARE: MR. JOHN GLENN BARCELON
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
1183500000XPharmacist17034NV

General Provider Information

NPI Number : 1710264536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN GLENN BARCELON
Provider Business Mailing Address
First Line : 6885 W LONE MOUNTAIN RD APT 253
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5813
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1445 W CRAIG RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0211
Country : US
Telephone Number : 702-649-3113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2011
Last Update Date : 11/08/2011

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Directions to “ MR. JOHN GLENN BARCELON ” Practice Location

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