MEDICARE: DR. SANDI IRENE BRYANT PHARM D

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	1835G0303X	Geriatric Pharmacist	12099	NC

General Provider Information

NPI Number	:	1033253497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDI IRENE BRYANT PHARM D

Provider Business Mailing Address
First Line	:	24 RAVENWOOD DR
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732-9724
Country	:	US
Telephone Number	:	828-651-9101
Fax Number	:	828-628-3516

Provider Business Practice Location Address
First Line	:	66 RETTA RD
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730-8767
Country	:	US
Telephone Number	:	828-628-3675
Fax Number	:	828-628-3516

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	04/29/2022

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