MEDICARE: MR. ROBERT S FLEECE R.PH

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	5302021010	MI

General Provider Information

NPI Number	:	1083742910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT S FLEECE R.PH

Provider Business Mailing Address
First Line	:	12168 BIRCHWOOD LN
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1642
Country	:	US
Telephone Number	:	810-695-5419
Fax Number	:

Provider Business Practice Location Address
First Line	:	12724 S SAGINAW ST
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1831
Country	:	US
Telephone Number	:	810-694-2500
Fax Number	:

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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Directions to “ MR. ROBERT S FLEECE R.PH” Practice Location

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