MEDICARE: MR. THOMAS EDWIN MCELROY

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	PS00015452	FL

General Provider Information

NPI Number	:	1962653766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS EDWIN MCELROY

Provider Business Mailing Address
First Line	:	7558 DOWNWINDS LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7116
Country	:	US
Telephone Number	:	561-433-3518
Fax Number	:

Provider Business Practice Location Address
First Line	:	7558 DOWNWINDS LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7116
Country	:	US
Telephone Number	:	561-433-3518
Fax Number	:

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

Provider Enumeration Date	:	10/10/2008
Last Update Date	:	10/10/2008

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