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NPI Code Detail

MEDICARE: KRYSTAL LYNN AMBURGEY

MEDICARE: KRYSTAL LYNN AMBURGEY
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
1183500000XPharmacist03334552OH

General Provider Information

NPI Number : 1306208848
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL LYNN AMBURGEY
Provider Business Mailing Address
First Line : 12110 LEBANON RD
Second Line :
City : SHARONVILLE
State : OH
Zip : 45241-1739
Country : US
Telephone Number : 513-769-8188
Fax Number :
Provider Business Practice Location Address
First Line : 12110 LEBANON RD
Second Line :
City : SHARONVILLE
State : OH
Zip : 45241-1739
Country : US
Telephone Number : 513-769-8188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2016
Last Update Date : 03/23/2016

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Directions to “ KRYSTAL LYNN AMBURGEY ” Practice Location

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