MEDICARE: MR. ROBERT LEE CECIL 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	RPH011905	GA

General Provider Information

NPI Number	:	1871750992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT LEE CECIL RPH

Provider Business Mailing Address
First Line	:	4045 D LINDLEY CIRCLE
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127
Country	:	US
Telephone Number	:	770-943-3566
Fax Number	:	770-943-0723

Provider Business Practice Location Address
First Line	:	4045 D LINDLEY CIRCLE
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127
Country	:	US
Telephone Number	:	770-943-3566
Fax Number	:	770-943-0723

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

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/16/2008

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