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General NPI Number Information
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NPI Number | 1255464319
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Entity Type | Individual
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Provider Name | MARY ELLEN CHAMBERLAIN RPH
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4085 WEDGE WOOD LANE
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City | THE VILLAGES
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State | FL
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Zip | 32162
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Country | US
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Telephone | 352-259-2844
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Fax | 352-259-3317
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Provider Business Mailing Address
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Address Line | 576 SMITHFIELD PL
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City | THE VILLAGES
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State | FL
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Zip | 32162-3316
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Country | US
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Telephone | 352-638-0399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS39456
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22501
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License Number State | MI
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