MEDICARE: DR. KENDALL E NOWAK 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	183500000X	Pharmacist	14147-40	WI
2	183500000X	Pharmacist	PS43380	FL

General Provider Information

NPI Number	:	1760784748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENDALL E NOWAK PHARM-D

Provider Business Mailing Address
First Line	:	4854 SUN CITY CENTER BLVD
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-6281
Country	:	US
Telephone Number	:	813-634-2924
Fax Number	:	813-634-5740

Provider Business Practice Location Address
First Line	:	4854 SUN CITY CENTER BLVD
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-6281
Country	:	US
Telephone Number	:	813-634-2924
Fax Number	:	813-634-5740

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

Provider Enumeration Date	:	11/24/2010
Last Update Date	:	07/26/2022

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