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NPI Code Detail

MEDICARE: RYAN PATRICK SYPOLT PHARM.D

MEDICARE: RYAN PATRICK SYPOLT PHARM.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
1183500000XPharmacist24563NC

General Provider Information

NPI Number : 1518376177
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN PATRICK SYPOLT PHARM.D
Provider Business Mailing Address
First Line : 1138 SABBATH HOME RD SW
Second Line :
City : HOLDEN BEACH
State : NC
Zip : 28462-5364
Country : US
Telephone Number : 724-977-2129
Fax Number :
Provider Business Practice Location Address
First Line : 1138 SABBATH HOME RD SW
Second Line :
City : HOLDEN BEACH
State : NC
Zip : 28462-5364
Country : US
Telephone Number : 724-977-2129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2014
Last Update Date : 08/07/2014

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Directions to “ RYAN PATRICK SYPOLT PHARM.D” Practice Location

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