MEDICARE: DR. RICHARD ROBERT GOBER PHARM.D.,CGP

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	T-09784	MS
2	183500000X	Pharmacist	019490	GA
3	183500000X	Pharmacist	5227	WV
4	183500000X	Pharmacist	4871	MT

General Provider Information

NPI Number	:	1952329229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ROBERT GOBER PHARM.D.,CGP

Provider Business Mailing Address
First Line	:	108 WOODLANDS PARK DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39047-8774
Country	:	US
Telephone Number	:	601-672-7270
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 WOODLANDS PARK DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39047-8774
Country	:	US
Telephone Number	:	601-672-7270
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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