MEDICARE: DR. JEFF LEWIS PHARMD, 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	03216479	OH

General Provider Information

NPI Number	:	1740806496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF LEWIS PHARMD, RPH

Provider Business Mailing Address
First Line	:	378 KELSEY PARK DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4504
Country	:	US
Telephone Number	:	330-607-2052
Fax Number	:

Provider Business Practice Location Address
First Line	:	378 KELSEY PARK DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4504
Country	:	US
Telephone Number	:	330-607-2052
Fax Number	:

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

Provider Enumeration Date	:	06/18/2020
Last Update Date	:	06/18/2020

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