MEDICARE: MR. LAWRENCE EDWARD MORRISON II 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	PS47245	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS47245	OTHER	FL	FLORIDA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1326547548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE EDWARD MORRISON II RPH

Provider Business Mailing Address
First Line	:	2923 CORINTHIAN AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-4401
Country	:	US
Telephone Number	:	904-389-5558
Fax Number	:	904-388-7392

Provider Business Practice Location Address
First Line	:	2923 CORINTHIAN AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-4401
Country	:	US
Telephone Number	:	904-389-5558
Fax Number	:	904-388-7392

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

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	02/02/2018

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