MEDICARE: ROBERT CATTERSON

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	PS20250	FL

General Provider Information

NPI Number	:	1841533510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT CATTERSON

Provider Business Mailing Address
First Line	:	5606 COUNTRY CLUB PKWY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-1747
Country	:	US
Telephone Number	:	772-696-3060
Fax Number	:

Provider Business Practice Location Address
First Line	:	5606 COUNTRY CLUB PKWY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-1747
Country	:	US
Telephone Number	:	772-696-3060
Fax Number	:

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

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	04/01/2013

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