MEDICARE: DARRELL B MCGEE PHARM. D.

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	PS36888	FL
2	1835P1200X	Pharmacotherapy Pharmacist	PS36888	FL

General Provider Information

NPI Number	:	1154665339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL B MCGEE PHARM. D.

Provider Business Mailing Address
First Line	:	9162 LAKE FISCHER BLVD
Second Line	:
City	:	GOTHA
State	:	FL
Zip	:	34734-5201
Country	:	US
Telephone Number	:	305-494-4479
Fax Number	:	407-303-9375

Provider Business Practice Location Address
First Line	:	9162 LAKE FISCHER BLVD
Second Line	:
City	:	GOTHA
State	:	FL
Zip	:	34734-5201
Country	:	US
Telephone Number	:	305-494-4479
Fax Number	:	407-303-9375

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

Provider Enumeration Date	:	11/12/2012
Last Update Date	:	11/12/2012

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