MEDICARE: MS. ROSEANN EDITH JOHNSON R.PH.

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	RP028093L	PA

General Provider Information

NPI Number	:	1114361722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSEANN EDITH JOHNSON R.PH.

Provider Business Mailing Address
First Line	:	364 SEDGEWOOD RD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-3127
Country	:	US
Telephone Number	:	215-554-1425
Fax Number	:

Provider Business Practice Location Address
First Line	:	364 SEDGEWOOD RD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-3127
Country	:	US
Telephone Number	:	215-554-1425
Fax Number	:

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

Provider Enumeration Date	:	04/25/2013
Last Update Date	:	04/25/2013

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