MEDICARE: DR. GAYLE SLIFKA PHARM.D., CGP

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	02022204335	VA
2	183500000X	Pharmacist	PS34362	FL

General Provider Information

NPI Number	:	1245231703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAYLE SLIFKA PHARM.D., CGP

Provider Business Mailing Address
First Line	:	2509 LOG CABIN RD
Second Line	:
City	:	MAIDENS
State	:	VA
Zip	:	23102-2227
Country	:	US
Telephone Number	:	804-556-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	2509 LOG CABIN RD
Second Line	:
City	:	MAIDENS
State	:	VA
Zip	:	23102-2227
Country	:	US
Telephone Number	:	804-556-5560
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/26/2011

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