MEDICARE: MS. VALRIE ROWENA ANDERSON 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	036412-1	NY

General Provider Information

NPI Number	:	1104148774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VALRIE ROWENA ANDERSON RPH

Provider Business Mailing Address
First Line	:	100 W KINGSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-3961
Country	:	US
Telephone Number	:	718-410-1288
Fax Number	:	718-410-1580

Provider Business Practice Location Address
First Line	:	100 W KINGSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-3961
Country	:	US
Telephone Number	:	718-410-1288
Fax Number	:	718-410-1580

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

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	02/23/2010

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