MEDICARE: MRS. RHONDA SKINNER RPH

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	24678	FL

General Provider Information

NPI Number	:	1790052272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RHONDA SKINNER RPH

Provider Business Mailing Address
First Line	:	7105 WEST MCNAB ROAD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068
Country	:	US
Telephone Number	:	954-718-6828
Fax Number	:	954-718-6833

Provider Business Practice Location Address
First Line	:	7105 W MCNAB ROAD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-5492
Country	:	US
Telephone Number	:	954-718-6828
Fax Number	:	954-718-6833

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

Provider Enumeration Date	:	11/28/2011
Last Update Date	:	11/28/2011

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