MEDICARE: MR. ROBERT SLAY JR. 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	7349	AL

General Provider Information

NPI Number	:	1144331935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT SLAY JR. RPH.

Provider Business Mailing Address
First Line	:	1508 BROWN DR SE
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-2981
Country	:	US
Telephone Number	:	256-435-5851
Fax Number	:	256-435-5617

Provider Business Practice Location Address
First Line	:	815 PELHAM RD S
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-2735
Country	:	US
Telephone Number	:	256-435-5851
Fax Number	:	256-435-5617

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. ROBERT SLAY JR. RPH.” Practice Location

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