Provider Demographics
NPI:1306159504
Name:BAHLMAN, JOHN A III (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:BAHLMAN
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:3198 WILLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-6610
Mailing Address - Country:US
Mailing Address - Phone:928-778-3181
Mailing Address - Fax:928-778-3491
Practice Address - Street 1:3198 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-6610
Practice Address - Country:US
Practice Address - Phone:928-778-3181
Practice Address - Fax:928-778-3491
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ6079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist