Healthcare Provider Details

I. General information

NPI: 1689775322
Provider Name (Legal Business Name): MARY GAISER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 COMMERCIAL WAY
SPRING HILL FL
34606-3810
US

IV. Provider business mailing address

14315 LINDEN DR
SPRING HILL FL
34609-6143
US

V. Phone/Fax

Practice location:
  • Phone: 352-666-4600
  • Fax: 352-686-9445
Mailing address:
  • Phone: 352-688-7019
  • Fax: 352-686-9445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS36527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: