MEDICARE: MR. JONATHAN DANDO MHS RPH CPC-A

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	5877	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5877	OTHER	SC	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1063497550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JONATHAN DANDO MHS RPH CPC-A

Provider Business Mailing Address
First Line	:	PO BOX 1027
Second Line	:
City	:	CHEROKEE
State	:	NC
Zip	:	28719-1027
Country	:	US
Telephone Number	:	828-497-9163
Fax Number	:

Provider Business Practice Location Address
First Line	:	1HOSPITAL ROAD
Second Line	:
City	:	CHEROKEE
State	:	NC
Zip	:	28719-1027
Country	:	US
Telephone Number	:	828-497-9163
Fax Number	:

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	02/26/2013

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