MEDICARE: MS. TANIA MCDERMOTT 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	PS28943	FL

General Provider Information

NPI Number	:	1063630531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TANIA MCDERMOTT RPH

Provider Business Mailing Address
First Line	:	240 ARLINGTON RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-5012
Country	:	US
Telephone Number	:	561-588-8740
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 DATURA ST
Second Line	:	SUITE 401
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5414
Country	:	US
Telephone Number	:	561-659-1270
Fax Number	:

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	05/25/2011

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