MEDICARE: MRS. ROSIE DARLENE COLEMAN 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	37964	TX

General Provider Information

NPI Number	:	1538473996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSIE DARLENE COLEMAN PHARMD

Provider Business Mailing Address
First Line	:	1793 INDIAN RDG
Second Line	:
City	:	OAK LEAF
State	:	TX
Zip	:	75154-5872
Country	:	US
Telephone Number	:	972-576-2996
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 S LANCASTER RD
Second Line	:	PHARMACY DEPARTMENT
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	972-824-8876
Fax Number	:

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

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	07/28/2010

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