MEDICARE: MR. DONALD WAYNE PADGETT 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	03215662	OH

General Provider Information

NPI Number	:	1356626600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD WAYNE PADGETT R.PH.

Provider Business Mailing Address
First Line	:	1014 CHANTICLEER WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1947
Country	:	US
Telephone Number	:	513-753-7578
Fax Number	:	513-753-7906

Provider Business Practice Location Address
First Line	:	719 OHIO PIKE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1947
Country	:	US
Telephone Number	:	513-753-7578
Fax Number	:	513-753-7906

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

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	10/19/2011

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