MEDICARE: DR. NOAH GARRETT 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	54157	CA

General Provider Information

NPI Number	:	1841609948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOAH GARRETT PHARMD

Provider Business Mailing Address
First Line	:	1020 HUNTINGTON DR
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 HUNTINGTON DR
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-1828
Country	:	US
Telephone Number	:	626-282-8431
Fax Number	:

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

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	08/04/2014

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