MEDICARE: DR. JOE V JOHN PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RP441976	PA

General Provider Information

NPI Number	:	1396995395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOE V JOHN PHARMD

Provider Business Mailing Address
First Line	:	1421 COOPER CIR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-6205
Country	:	US
Telephone Number	:	610-517-6327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 W CHESTER PIKE
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-7705
Country	:	US
Telephone Number	:	610-692-2730
Fax Number	:

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

Provider Enumeration Date	:	09/25/2008
Last Update Date	:	09/25/2008

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