MEDICARE: DR. ASHLEY GANN PHARMD

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	21443	AL

General Provider Information

NPI Number	:	1467117895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY GANN PHARMD

Provider Business Mailing Address
First Line	:	5295 TAMMY LITTLE DRIVE
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771
Country	:	US
Telephone Number	:	256-228-7179
Fax Number	:

Provider Business Practice Location Address
First Line	:	5295 TAMMY LITTLE DRIVE
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771
Country	:	US
Telephone Number	:	256-228-7179
Fax Number	:

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

Provider Enumeration Date	:	11/01/2021
Last Update Date	:	11/01/2021

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