MEDICARE: ANNMARIE MOHAN PHARMD

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	PS50664	FL

General Provider Information

NPI Number	:	1013317916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNMARIE MOHAN PHARMD

Provider Business Mailing Address
First Line	:	2511 E ATLANTIC BLVD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5217
Country	:	US
Telephone Number	:	561-786-7969
Fax Number	:	954-786-7979

Provider Business Practice Location Address
First Line	:	2511 E ATLANTIC BLVD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5217
Country	:	US
Telephone Number	:	561-786-7969
Fax Number	:	954-786-7979

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

Provider Enumeration Date	:	08/27/2014
Last Update Date	:	08/27/2014

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