MEDICARE: DR. BRIANNA C BARTON PHARMD

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	051295062	IL
2	183500000X	Pharmacist	2011023407	MO

General Provider Information

NPI Number	:	1841572583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIANNA C BARTON PHARMD

Provider Business Mailing Address
First Line	:	620 KINLOCH AVE
Second Line	:
City	:	COLLINSVILLE
State	:	IL
Zip	:	62234-4450
Country	:	US
Telephone Number	:	309-251-8705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1190 COLLINSVILLE CROSSING BLVD
Second Line	:
City	:	COLLINSVILLE
State	:	IL
Zip	:	62234-1880
Country	:	US
Telephone Number	:	618-343-0297
Fax Number	:

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

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	09/19/2011

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