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General NPI Number Information
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NPI Number | 1396802468
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Entity Type | Individual
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Provider Name | EPHREM DEGEFU R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2215 N MILITARY TRL STE L
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-2901
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Country | US
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Telephone | 561-683-1095
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Fax | 561-683-0591
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Provider Business Mailing Address
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Address Line | 740 BOCCE CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-1532
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Country | US
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Telephone | 561-312-1847
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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 | PS0026179
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License Number State | FL
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