MEDICARE: SANDRA E BAKER 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	21247	FL

General Provider Information

NPI Number	:	1790752095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA E BAKER R.PH

Provider Business Mailing Address
First Line	:	14226 WELLESLEY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-2587
Country	:	US
Telephone Number	:	813-767-2349
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-3847
Country	:	US
Telephone Number	:	813-936-9598
Fax Number	:

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

Provider Enumeration Date	:	03/06/2006
Last Update Date	:	07/08/2007

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