MEDICARE: ROSE BRANSTUTTER 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	9262	TN

General Provider Information

NPI Number	:	1548572746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE BRANSTUTTER RPH

Provider Business Mailing Address
First Line	:	2399 MCGRADY
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312
Country	:	US
Telephone Number	:	423-559-9094
Fax Number	:

Provider Business Practice Location Address
First Line	:	2399 MCGRADY DR SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-7147
Country	:	US
Telephone Number	:	423-559-9094
Fax Number	:

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

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	07/06/2010

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Directions to “ ROSE BRANSTUTTER RPH” Practice Location

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