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NPI Code Detail

MEDICARE: MR. MICHAEL PAUL MANNO RPH

MEDICARE: MR. MICHAEL PAUL MANNO 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
1183500000XPharmacist11468SC

General Provider Information

NPI Number : 1689996522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL PAUL MANNO RPH
Provider Business Mailing Address
First Line : 11063 HOLIDAY COVE DR
Second Line :
City : FORT MILL
State : SC
Zip : 29708-7219
Country : US
Telephone Number : 803-396-8891
Fax Number :
Provider Business Practice Location Address
First Line : 1716 PLEASANT RD
Second Line :
City : FORT MILL
State : SC
Zip : 29708-7815
Country : US
Telephone Number : 803-802-7644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2010
Last Update Date : 02/19/2010

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Directions to “ MR. MICHAEL PAUL MANNO RPH” Practice Location

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