MEDICARE: MR. MAURICE HENRY BARNETT III 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	PS33363	FL

General Provider Information

NPI Number	:	1841597192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAURICE HENRY BARNETT III RPH.

Provider Business Mailing Address
First Line	:	1115 45TH ST
Second Line	:	SUITE 3
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2376
Country	:	US
Telephone Number	:	561-296-3795
Fax Number	:	561-296-3796

Provider Business Practice Location Address
First Line	:	1115 45TH ST
Second Line	:	SUITE 3
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2376
Country	:	US
Telephone Number	:	561-296-3795
Fax Number	:	561-296-3796

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

Provider Enumeration Date	:	02/23/2011
Last Update Date	:	02/23/2011

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