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NPI Code Detail

MEDICARE: SAINT JOSEPH BEREA HOSPITAL OUTPATIENT PHARMACY

MEDICARE: SAINT JOSEPH BEREA HOSPITAL OUTPATIENT PHARMACY
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
1183500000XPharmacist09724KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P07094OTHERKYSTATE LICENSE
31813333OTHERKYNABP NUMBER

General Provider Information

NPI Number : 1396743894
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINT JOSEPH BEREA HOSPITAL OUTPATIENT PHARMACY
Provider Business Mailing Address
First Line : 305 ESTILL ST
Second Line :
City : BEREA
State : KY
Zip : 40403-1742
Country : US
Telephone Number : 859-986-6541
Fax Number : 859-986-2697
Provider Business Practice Location Address
First Line : 305 ESTILL ST
Second Line :
City : BEREA
State : KY
Zip : 40403-1742
Country : US
Telephone Number : 859-986-6541
Fax Number : 859-986-2697
Authorized Official
Title or Position : PHARMACY MANAGER
Name : DR. JOANNE D. O'KANE
Credential : PHARMD
Telephone Number : 859-986-6541
Provider Enumeration Date : 07/08/2005
Last Update Date : 09/07/2007

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Directions to “SAINT JOSEPH BEREA HOSPITAL OUTPATIENT PHARMACY ” Practice Location

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