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General NPI Number Information
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NPI Number | 1720170798
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Entity Type | Individual
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Provider Name | CHRISTOPHER C GREENWELL RPH
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1535 N SINGLETON AVE WINN DIXIE PHARMACY
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City | TITUSVILLE
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State | FL
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Zip | 32796-1647
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Country | US
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Telephone | 321-264-2055
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Fax | 321-267-4845
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Provider Business Mailing Address
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Address Line | 207 OLMSTEAD DR
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City | TITUSVILLE
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State | FL
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Zip | 32780-5722
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Country | US
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Telephone |
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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 | PS29672
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License Number State | FL
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