MEDICARE: MRS. DANA P ELMORE 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	PS20390	FL

General Provider Information

NPI Number	:	1972841245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANA P ELMORE RPH

Provider Business Mailing Address
First Line	:	2095 W LAKE HAMILTON DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-9217
Country	:	US
Telephone Number	:	863-293-4845
Fax Number	:	863-325-8271

Provider Business Practice Location Address
First Line	:	6031 CYPRESS GARDENS BLVD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-4115
Country	:	US
Telephone Number	:	863-324-1557
Fax Number	:	863-325-8271

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

Provider Enumeration Date	:	01/22/2013
Last Update Date	:	01/22/2013

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