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NPI Code Detail

MEDICARE: MRS. JERI LYNN TAYLOR RPH

MEDICARE: MRS. JERI LYNN TAYLOR RPH
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
1183500000XPharmacist26019907AIN

General Provider Information

NPI Number : 1417230913
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JERI LYNN TAYLOR RPH
Provider Business Mailing Address
First Line : 6191 N KEYSTONE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-2423
Country : US
Telephone Number : 317-257-6746
Fax Number : 317-257-6847
Provider Business Practice Location Address
First Line : 6191 N KEYSTONE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-2423
Country : US
Telephone Number : 317-257-6746
Fax Number : 317-257-6847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 09/21/2011

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