MEDICARE: MR. GARY CYRAN RPH

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	24859	NC
2	183500000X	Pharmacist	044918	NY

General Provider Information

NPI Number	:	1275865362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY CYRAN RPH

Provider Business Mailing Address
First Line	:	1419 E ANDREWS AVE
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-5202
Country	:	US
Telephone Number	:	252-762-0156
Fax Number	:	252-762-0159

Provider Business Practice Location Address
First Line	:	1419 E ANDREWS AVE
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-5202
Country	:	US
Telephone Number	:	252-762-0156
Fax Number	:	252-762-0159

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

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	10/29/2015

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