MEDICARE: DR. JUNE MARIE GOSE PHARM.D.

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	15149	MD

General Provider Information

NPI Number	:	1891780169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUNE MARIE GOSE PHARM.D.

Provider Business Mailing Address
First Line	:	7010 LENNOX AVE
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6314
Country	:	US
Telephone Number	:	410-796-5643
Fax Number	:

Provider Business Practice Location Address
First Line	:	8186 LARK BROWN RD
Second Line	:	SUITE 101
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6420
Country	:	US
Telephone Number	:	443-620-9990
Fax Number	:	443-620-9993

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	07/08/2007

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