MEDICARE: COMPLETE PHARMACY SOLUTIONS

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	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336L0003X	Long Term Care Pharmacy	021971800	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2121104	OTHER		PK

General Provider Information

NPI Number	:	1063648657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE PHARMACY SOLUTIONS

Provider Business Mailing Address
First Line	:	9874 WINDISCH RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-3806
Country	:	US
Telephone Number	:	513-644-1600
Fax Number	:	513-644-1580

Provider Business Practice Location Address
First Line	:	9874 WINDISCH RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-3806
Country	:	US
Telephone Number	:	513-644-1600
Fax Number	:	513-644-1580

Authorized Official
Title or Position	:	MANAGER
Name	:	THOMAS HAMMONS
Credential	:
Telephone Number	:	513-644-1594

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	02/23/2015

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Directions to “COMPLETE PHARMACY SOLUTIONS ” Practice Location

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