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NPI Code Detail

MEDICARE: MARK EDWARD GAYHEART RPH

MEDICARE:   MARK EDWARD GAYHEART  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
1183500000XPharmacist20774AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120774OTHERALPHARMACIST LICENCE NUMBER

General Provider Information

NPI Number : 1477193241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK EDWARD GAYHEART RPH
Provider Business Mailing Address
First Line : 1061 HIGHWAY 280
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-4622
Country : US
Telephone Number : 256-234-5156
Fax Number : 256-234-5428
Provider Business Practice Location Address
First Line : 1061 HIGHWAY 280
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-4622
Country : US
Telephone Number : 256-234-5156
Fax Number : 256-243-5428
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2020
Last Update Date : 01/09/2020

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Directions to “ MARK EDWARD GAYHEART RPH” Practice Location

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