MEDICARE: MRS. JULIE ARTLEY RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS35092	FL

General Provider Information

NPI Number	:	1003186040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE ARTLEY RPH

Provider Business Mailing Address
First Line	:	1213 PALM BAY RD, NE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32905
Country	:	US
Telephone Number	:	321-646-4602
Fax Number	:

Provider Business Practice Location Address
First Line	:	1213 PALM BAY RD, NE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32905
Country	:	US
Telephone Number	:	321-646-4602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2012
Last Update Date	:	01/09/2012

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