MEDICARE: JUDY ROWE ST JOHN 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	7930	AL
2	183500000X	Pharmacist	PS011862	GA
3	183500000X	Pharmacist	PS20113	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7930	OTHER	AL	PHARMACIST LICENSE
2	PS20113	OTHER	FL	PHARMACIST LICENSE
3	PS011862	OTHER	GA	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1316016124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY ROWE ST JOHN RPH

Provider Business Mailing Address
First Line	:	21075 RABREN RD
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36421-8115
Country	:	US
Telephone Number	:	334-222-9646
Fax Number	:	334-222-9646

Provider Business Practice Location Address
First Line	:	837 S THREE NOTCH ST
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36420-5321
Country	:	US
Telephone Number	:	334-222-1141
Fax Number	:	334-222-8361

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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Directions to “ JUDY ROWE ST JOHN RPH” Practice Location

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