MEDICARE: DALE B. THRESS 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	PS0024689	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	034616	OTHER	NY	NY LICENSE
2	PS0024689	OTHER	FL	FL LICENSE

General Provider Information

NPI Number	:	1417125857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALE B. THRESS RPH

Provider Business Mailing Address
First Line	:	2778 N ROOSEVELT BLVD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3930
Country	:	US
Telephone Number	:	305-294-0658
Fax Number	:	305-294-6378

Provider Business Practice Location Address
First Line	:	2778 N ROOSEVELT BLVD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-3930
Country	:	US
Telephone Number	:	305-294-0658
Fax Number	:	305-294-6378

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

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

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Directions to “ DALE B. THRESS RPH” Practice Location

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