MEDICARE: MS. TAMRA RENEE POPE R.PH.

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	PS0032725	FL

General Provider Information

NPI Number	:	1588775100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMRA RENEE POPE R.PH.

Provider Business Mailing Address
First Line	:	329 SW DEPUTY J DAVIS LN
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32024-3739
Country	:	US
Telephone Number	:	386-752-3202
Fax Number	:

Provider Business Practice Location Address
First Line	:	297 N MARION AVE
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-2866
Country	:	US
Telephone Number	:	386-752-1793
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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