MEDICARE: MR. ANDREAS P. XANTHOPOULOS PHARM D, 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	050128	NY

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	:	1902086820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREAS P. XANTHOPOULOS PHARM D, RPH

Provider Business Mailing Address
First Line	:	2748 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2808
Country	:	US
Telephone Number	:	718-829-6808
Fax Number	:	718-829-6236

Provider Business Practice Location Address
First Line	:	2748 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2808
Country	:	US
Telephone Number	:	718-829-6808
Fax Number	:	718-829-6236

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

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	11/08/2007

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