MEDICARE: MR. ROBERT L WESTBROOK JR. 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	03-3-9330	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FV93161	OTHER		MEDICARE B PIN

General Provider Information

NPI Number	:	1306852470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT L WESTBROOK JR. R.PH.

Provider Business Mailing Address
First Line	:	1400 S.R. 125
Second Line	:
City	:	AMELIA
State	:	OH
Zip	:	45102-1328
Country	:	US
Telephone Number	:	513-753-4700
Fax Number	:	513-753-3401

Provider Business Practice Location Address
First Line	:	1400 S.R. 125
Second Line	:
City	:	AMELIA
State	:	OH
Zip	:	45102-1328
Country	:	US
Telephone Number	:	513-753-4700
Fax Number	:	513-753-3401

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	01/30/2008

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