MEDICARE: JOHN WAYNE DENMAN

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	28RI01781500	NJ
2	183500000X	Pharmacist	RP446424	PA
3	183500000X	Pharmacist	PS27582	FL

General Provider Information

NPI Number	:	1568174472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WAYNE DENMAN

Provider Business Mailing Address
First Line	:	2888 NE 35TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-2006
Country	:	US
Telephone Number	:	215-208-7494
Fax Number	:

Provider Business Practice Location Address
First Line	:	2888 NE 35TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-2006
Country	:	US
Telephone Number	:	215-208-7494
Fax Number	:

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

Provider Enumeration Date	:	12/22/2022
Last Update Date	:	12/22/2022

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Directions to “ JOHN WAYNE DENMAN ” Practice Location

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