MEDICARE: CHARITY A RAUSCH 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	PS38150	FL

General Provider Information

NPI Number	:	1801883517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITY A RAUSCH RPH

Provider Business Mailing Address
First Line	:	9640 HORNE LN
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	33928-6280
Country	:	US
Telephone Number	:	239-947-7928
Fax Number	:

Provider Business Practice Location Address
First Line	:	3033 WINKLER AVENUE EXT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-9413
Country	:	US
Telephone Number	:	239-939-3939
Fax Number	:

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	07/08/2007

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