MEDICARE: MR. GREGORY BRADFORD CHATTERTON R.PH. C.PH.

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	PS18239	FL

General Provider Information

NPI Number	:	1396838702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY BRADFORD CHATTERTON R.PH. C.PH.

Provider Business Mailing Address
First Line	:	21197 WHITE OAK AVE
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-1716
Country	:	US
Telephone Number	:	561-716-1127
Fax Number	:	561-487-6043

Provider Business Practice Location Address
First Line	:	21197 WHITE OAK AVE
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-1716
Country	:	US
Telephone Number	:	561-716-1127
Fax Number	:	561-487-6043

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

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	05/09/2011

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