MEDICARE: DACY REYNOLDS ATCHISON 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	183500000X	Pharmacist	20540	AL

General Provider Information

NPI Number	:	1225517691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DACY REYNOLDS ATCHISON PHARM.D.

Provider Business Mailing Address
First Line	:	160 COTTON CREEK DR STE 100
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-2850
Country	:	US
Telephone Number	:	251-948-2781
Fax Number	:	251-948-3187

Provider Business Practice Location Address
First Line	:	160 COTTON CREEK DR STE 100
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-2850
Country	:	US
Telephone Number	:	251-948-2781
Fax Number	:	251-948-3187

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

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	08/07/2018

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