MEDICARE: MR. DAVID RICHARD TABER 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	35676	CA

General Provider Information

NPI Number	:	1851546105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID RICHARD TABER RPH

Provider Business Mailing Address
First Line	:	PO BOX 548
Second Line	:
City	:	SELLS
State	:	AZ
Zip	:	85634-0548
Country	:	US
Telephone Number	:	951-533-3693
Fax Number	:

Provider Business Practice Location Address
First Line	:	5050 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2709
Country	:	US
Telephone Number	:	951-533-3693
Fax Number	:

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

Provider Enumeration Date	:	11/28/2008
Last Update Date	:	11/28/2008

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