MEDICARE: DR. NICOLE MARIE GASBARRO 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	18230	NC

General Provider Information

NPI Number	:	1568766376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE MARIE GASBARRO PHARMD

Provider Business Mailing Address
First Line	:	4100 CARMEL RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-6150
Country	:	US
Telephone Number	:	704-576-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 CARMEL RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-6150
Country	:	US
Telephone Number	:	704-542-1806
Fax Number	:

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

Provider Enumeration Date	:	01/08/2011
Last Update Date	:	01/08/2011

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