MEDICARE: PAUL G. TAYLOR R.PH., CFTS

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	09264	NC
2	332B00000X	Durable Medical Equipment & Medical Supplies	CFTS0708	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548419013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL G. TAYLOR R.PH., CFTS

Provider Business Mailing Address
First Line	:	114 SURFSIDE LN
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-7464
Country	:	US
Telephone Number	:	704-664-1999
Fax Number	:	704-664-1999

Provider Business Practice Location Address
First Line	:	6360 E NC 150 HWY
Second Line	:	TAYLOR MED PHARMACY/GENERAL STORE
City	:	SHERRILLS FORD
State	:	NC
Zip	:	28673-9404
Country	:	US
Telephone Number	:	704-483-9150
Fax Number	:	704-664-1999

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

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	05/13/2009

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