MEDICARE: THE BARLEO CORPORATION

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	332B00000X	Durable Medical Equipment & Medical Supplies	04620	TX
2	3336C0003X	Community/Retail Pharmacy	04620	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720037393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BARLEO CORPORATION

Provider Business Mailing Address
First Line	:	1316 SYCAMORE SCHOOL RD
Second Line	:	STE. 130
City	:	FORT WORTH
State	:	TX
Zip	:	76134-4997
Country	:	US
Telephone Number	:	817-293-2441
Fax Number	:	817-568-0955

Provider Business Practice Location Address
First Line	:	1316 SYCAMORE SCHOOL RD
Second Line	:	STE. 130
City	:	FORT WORTH
State	:	TX
Zip	:	76134-4997
Country	:	US
Telephone Number	:	817-293-2441
Fax Number	:	817-568-0955

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD LYNN IRBY
Credential	:	RPH
Telephone Number	:	817-293-2441

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	11/30/2007

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Directions to “THE BARLEO CORPORATION ” Practice Location

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