MEDICARE: DR. CHRISTOPHER JAMES LAURSEN PHARM D

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	PS0031687	FL

General Provider Information

NPI Number	:	1790022655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER JAMES LAURSEN PHARM D

Provider Business Mailing Address
First Line	:	4250 ALAFAYA TRL
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9412
Country	:	US
Telephone Number	:	407-366-9720
Fax Number	:	407-366-3292

Provider Business Practice Location Address
First Line	:	4250 ALAFAYA TRL
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9412
Country	:	US
Telephone Number	:	407-366-9720
Fax Number	:	407-366-3292

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

Provider Enumeration Date	:	01/12/2013
Last Update Date	:	01/12/2013

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