MEDICARE: MR. BILLY RAY POE 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	9234	AL

General Provider Information

NPI Number	:	1942356050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILLY RAY POE RPH

Provider Business Mailing Address
First Line	:	5324 WINCHESTER RD
Second Line	:
City	:	NEW MARKET
State	:	AL
Zip	:	35761-7430
Country	:	US
Telephone Number	:	256-379-4670
Fax Number	:	256-379-4680

Provider Business Practice Location Address
First Line	:	5324 WINCHESTER RD
Second Line	:
City	:	NEW MARKET
State	:	AL
Zip	:	35761-7430
Country	:	US
Telephone Number	:	256-379-4670
Fax Number	:	256-379-4680

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/08/2007

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