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NPI 1417257619

NPI 1417257619 : REX MICHAEL PARKERSON PHARMACIST : DUBLIN, GA

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General NPI Number Information
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    NPI Number           |    1417257619
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    Entity Type          |    Individual 
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    Provider Name        |    REX MICHAEL PARKERSON PHARMACIST
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/22/2010
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    Last Update Date     |    10/22/2010
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Provider Practice Location Address
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    Address Line         |    2103 VETERANS BLVD UNIT 2 
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    City                 |    DUBLIN
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    State                |    GA
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    Zip                  |    31021
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    Country              |    US
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    Telephone            |    478-272-1210
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 4000 
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    City                 |    DUBLIN
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    State                |    GA
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    Zip                  |    31040-9000
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    Country              |    US
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    Telephone            |    478-272-1210
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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       |    9962
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    License Number State |    GA
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