MEDICARE: LOUIS BASSI

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	PS39054	FL

General Provider Information

NPI Number	:	1992042857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS BASSI

Provider Business Mailing Address
First Line	:	1005 NW 22ND AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 NW 22ND AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8312
Country	:	US
Telephone Number	:	561-732-6802
Fax Number	:	561-732-6823

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

Provider Enumeration Date	:	01/12/2013
Last Update Date	:	01/12/2013

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Directions to “ LOUIS BASSI ” Practice Location

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