MEDICARE: KIMBERLY ERIN ANDERSON PHARMD

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	PS51225	FL

General Provider Information

NPI Number	:	1437586948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ERIN ANDERSON PHARMD

Provider Business Mailing Address
First Line	:	7105 W MCNAB RD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-5492
Country	:	US
Telephone Number	:	954-718-6828
Fax Number	:

Provider Business Practice Location Address
First Line	:	7105 W MCNAB RD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-5492
Country	:	US
Telephone Number	:	954-718-6828
Fax Number	:

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

Provider Enumeration Date	:	09/28/2013
Last Update Date	:	09/28/2013

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