MEDICARE: DR. RICHARD MICHAEL DAVIES R.PH., PH. D.

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	PS21157	FL

General Provider Information

NPI Number	:	1497038954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD MICHAEL DAVIES R.PH., PH. D.

Provider Business Mailing Address
First Line	:	3799 MURRELL RD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4710
Country	:	US
Telephone Number	:	321-631-2755
Fax Number	:	321-631-3175

Provider Business Practice Location Address
First Line	:	3799 MURRELL RD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4710
Country	:	US
Telephone Number	:	321-631-2755
Fax Number	:	321-631-3175

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

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	09/21/2011

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