MEDICARE: DR. JEFFREY D TAYLOR PHARMD

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	16805	AL

General Provider Information

NPI Number	:	1962749804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY D TAYLOR PHARMD

Provider Business Mailing Address
First Line	:	25771 PERDIDO BEACH BLVD
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-6107
Country	:	US
Telephone Number	:	251-980-1445
Fax Number	:	251-980-1468

Provider Business Practice Location Address
First Line	:	25771 PERDIDO BEACH BLVD
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-6107
Country	:	US
Telephone Number	:	251-980-1445
Fax Number	:	251-980-1468

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

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	01/11/2013

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