MEDICARE: MISS FOZIA OMER AHMED 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	PS30475	FL

General Provider Information

NPI Number	:	1326317272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS FOZIA OMER AHMED RPH

Provider Business Mailing Address
First Line	:	9998 FRONT BEACH RD
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-4137
Country	:	US
Telephone Number	:	850-236-1383
Fax Number	:	850-236-7220

Provider Business Practice Location Address
First Line	:	9998 FRONT BEACH RD
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-4137
Country	:	US
Telephone Number	:	850-236-1383
Fax Number	:	850-236-7220

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

Provider Enumeration Date	:	12/21/2011
Last Update Date	:	12/21/2011

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