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NPI Code Detail

MEDICARE: JAMES M GILLIS RPH, CPH

MEDICARE: JAMES M GILLIS RPH, CPH
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
1183500000XPharmacistPU 5206FL
2183500000XPharmacistPS 30591FL

General Provider Information

NPI Number : 1235411786
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES M GILLIS RPH, CPH
Provider Business Mailing Address
First Line : 600 ANSIN BLVD
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-2118
Country : US
Telephone Number : 954-987-4646
Fax Number :
Provider Business Practice Location Address
First Line : 600 ANSIN BLVD
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-2118
Country : US
Telephone Number : 954-987-4646
Fax Number : 954-455-1378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2011
Last Update Date : 10/15/2011

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