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NPI Code Detail

MEDICARE: ERICA JANINE CHANDLER

MEDICARE: ERICA JANINE CHANDLER
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
1183500000XPharmacistPS34989FL

General Provider Information

NPI Number : 1811597610
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA JANINE CHANDLER
Provider Business Mailing Address
First Line : 4400 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-1029
Country : US
Telephone Number : 850-574-4613
Fax Number : 850-574-3966
Provider Business Practice Location Address
First Line : 4400 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-1029
Country : US
Telephone Number : 850-574-4613
Fax Number : 850-576-3966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2020
Last Update Date : 10/30/2020

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Directions to “ ERICA JANINE CHANDLER ” Practice Location

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