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NPI Code Detail

MEDICARE: MRS. CHERYL ANN GANZER RPH

MEDICARE: MRS. CHERYL ANN GANZER 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
1183500000XPharmacistPS0027130FL

General Provider Information

NPI Number : 1295017457
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL ANN GANZER RPH
Provider Business Mailing Address
First Line : 4600 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-7339
Country : US
Telephone Number : 321-269-7573
Fax Number : 321-383-3149
Provider Business Practice Location Address
First Line : 1587 N COURTENAY PKWY
Second Line :
City : MERRITT ISLAND
State : FL
Zip : 32953-4454
Country : US
Telephone Number : 321-459-1647
Fax Number : 321-459-1201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 12/22/2022

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