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NPI Code Detail

MEDICARE: SHELDON KEITH COFFMAN JR. RPH

MEDICARE: SHELDON KEITH COFFMAN JR. 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
1183500000XPharmacistPS22370FL

General Provider Information

NPI Number : 1023507308
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELDON KEITH COFFMAN JR. RPH
Provider Business Mailing Address
First Line : 28263 CHURCH RD
Second Line :
City : BROOKSVILLE
State : FL
Zip : 34602-6232
Country : US
Telephone Number : 352-442-1884
Fax Number :
Provider Business Practice Location Address
First Line : 14306 7TH ST
Second Line :
City : DADE CITY
State : FL
Zip : 33523-3434
Country : US
Telephone Number : 352-567-2238
Fax Number : 352-567-2259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2018
Last Update Date : 05/02/2018

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