MEDICARE: MR. PHILLIP SAUNDERS SR. R.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	PS20719	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS20719	OTHER	FL	FLORIDA BOARD OF PHARMACY (MEDICAL QUALITY ASSURANCE)

General Provider Information

NPI Number	:	1639626062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHILLIP SAUNDERS SR. R.PH.

Provider Business Mailing Address
First Line	:	PO BOX 4219
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33509-4219
Country	:	US
Telephone Number	:	813-516-8858
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 N TAMPA ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-1430
Country	:	US
Telephone Number	:	813-223-4303
Fax Number	:	813-223-4149

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

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	01/10/2018

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