MEDICARE: GABRIELLE ALEXIS GILL 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
1	390200000X	Student in an Organized Health Care Education/Training Program	S12652	AL

General Provider Information

NPI Number	:	1710517222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE ALEXIS GILL PHARM D.

Provider Business Mailing Address
First Line	:	2785 OAKRIDGE WEST DR
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-8707
Country	:	US
Telephone Number	:	478-207-0242
Fax Number	:

Provider Business Practice Location Address
First Line	:	2785 OAKRIDGE WEST DR
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36608-8707
Country	:	US
Telephone Number	:	478-207-0242
Fax Number	:

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

Provider Enumeration Date	:	01/23/2020
Last Update Date	:	05/14/2022

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