MEDICARE: CHELSEA WINTZINGER 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	41517	TN
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	19995	AL

General Provider Information

NPI Number	:	1114558293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA WINTZINGER RPH

Provider Business Mailing Address
First Line	:	201 JEFFERSON ST NW APT 312
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5027
Country	:	US
Telephone Number	:	256-655-5533
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 OAKWOOD AVE NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35810-4404
Country	:	US
Telephone Number	:	256-539-5136
Fax Number	:

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

Provider Enumeration Date	:	01/28/2020
Last Update Date	:	01/28/2020

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Directions to “ CHELSEA WINTZINGER RPH” Practice Location

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