MEDICARE: MRS. JEWEL SHARON CAMILLE RICHARDS-LEE 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	PS36963	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811975766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JEWEL SHARON CAMILLE RICHARDS-LEE RPH

Provider Business Mailing Address
First Line	:	125 WOODSTORK WAY
Second Line	:
City	:	FROSTPROOF
State	:	FL
Zip	:	33843-9553
Country	:	US
Telephone Number	:	863-635-4272
Fax Number	:	863-635-4272

Provider Business Practice Location Address
First Line	:	586 US HIGHWAY 27 N
Second Line	:
City	:	LAKE PLACID
State	:	FL
Zip	:	33852-9508
Country	:	US
Telephone Number	:	863-699-2182
Fax Number	:	863-659-4176

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

Provider Enumeration Date	:	01/01/2006
Last Update Date	:	03/28/2017

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