MEDICARE: MICHAEL AWAD R.PH, C.C.P.

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	28RI02888000	NJ
2	183500000X	Pharmacist	184	VI
3	183500000X	Pharmacist	RP441764	PA
4	183500000X	Pharmacist	052278	NY

General Provider Information

NPI Number	:	1275684425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL AWAD R.PH, C.C.P.

Provider Business Mailing Address
First Line	:	27 HAMILTON DR N
Second Line	:
City	:	NORTH CALDWELL
State	:	NJ
Zip	:	07006-4630
Country	:	US
Telephone Number	:	973-228-6980
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 HAMILTON DR N
Second Line	:
City	:	NORTH CALDWELL
State	:	NJ
Zip	:	07006-4630
Country	:	US
Telephone Number	:	973-228-6980
Fax Number	:

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	11/16/2011

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