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NPI Code Detail

MEDICARE: GARY ALLEN PERKINS

MEDICARE:   GARY ALLEN PERKINS
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
1183500000XPharmacistPS47629FL

General Provider Information

NPI Number : 1144735200
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY ALLEN PERKINS
Provider Business Mailing Address
First Line : 2038 US HIGHWAY 98 W
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-5322
Country : US
Telephone Number : 850-267-0582
Fax Number : 850-267-0582
Provider Business Practice Location Address
First Line : 2038 US HIGHWAY 98 W
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-5322
Country : US
Telephone Number : 850-267-0582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2017
Last Update Date : 12/11/2017

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Directions to “ GARY ALLEN PERKINS ” Practice Location

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