MEDICARE: MR. GARY W MARSH 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	PS11785	FL

General Provider Information

NPI Number	:	1356614044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY W MARSH RPH

Provider Business Mailing Address
First Line	:	301 N TYNDALL PKWY
Second Line	:
City	:	CALLAWAY
State	:	FL
Zip	:	32404-6124
Country	:	US
Telephone Number	:	850-522-5321
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N TYNDALL PKWY
Second Line	:
City	:	CALLAWAY
State	:	FL
Zip	:	32404-6124
Country	:	US
Telephone Number	:	850-522-5321
Fax Number	:

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

Provider Enumeration Date	:	02/11/2012
Last Update Date	:	05/10/2026

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