MEDICARE: MR. CHRISTOPHER RAY WEEKS R PH

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	PH7231	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1037565	OTHER		NABPH

General Provider Information

NPI Number	:	1366413049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER RAY WEEKS R PH

Provider Business Mailing Address
First Line	:	PO BOX 432
Second Line	:	132 EE HWY 20
City	:	FREEPORT
State	:	FL
Zip	:	32439
Country	:	US
Telephone Number	:	850-835-2028
Fax Number	:	850-835-2028

Provider Business Practice Location Address
First Line	:	132 E HWY 20
Second Line	:
City	:	FREEPORT
State	:	FL
Zip	:	32439
Country	:	US
Telephone Number	:	850-835-2028
Fax Number	:	850-835-2028

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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