MEDICARE: AUSTIN TAYLOR TAYLOR 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	PH60659286	WA

General Provider Information

NPI Number	:	1740732254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN TAYLOR TAYLOR PHARM,D

Provider Business Mailing Address
First Line	:	5025 E SPRAGUE AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-0814
Country	:	US
Telephone Number	:	509-795-3601
Fax Number	:

Provider Business Practice Location Address
First Line	:	5025 E SPRAGUE AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-0814
Country	:	US
Telephone Number	:	509-795-3601
Fax Number	:

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

Provider Enumeration Date	:	10/31/2016
Last Update Date	:	10/31/2016

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