MEDICARE: MR. WILLIAM DAVID ANDREWS RPH CPH PD

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	PS0011979	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	R4816	OTHER	FL	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1054446	OTHER		NABP

General Provider Information

NPI Number	:	1912071192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM DAVID ANDREWS RPH CPH PD

Provider Business Mailing Address
First Line	:	1637 NE 36TH STREET
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6279
Country	:	US
Telephone Number	:	954-942-0920
Fax Number	:	954-942-0921

Provider Business Practice Location Address
First Line	:	1637 NE 36TH STREET
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6279
Country	:	US
Telephone Number	:	954-942-0920
Fax Number	:	954-942-0921

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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