MEDICARE: TAYLOR GAYNOR 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
1	183500000X	Pharmacist	03232633	OH
2	183500000X	Pharmacist	26026478A	IN
3	183500000X	Pharmacist	051297452	IL

General Provider Information

NPI Number	:	1437591393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR GAYNOR RPH

Provider Business Mailing Address
First Line	:	6970 CORPORATE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1928
Country	:	US
Telephone Number	:	888-696-9595
Fax Number	:	888-881-8585

Provider Business Practice Location Address
First Line	:	6970 CORPORATE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1928
Country	:	US
Telephone Number	:	888-696-9595
Fax Number	:	888-881-8585

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

Provider Enumeration Date	:	07/20/2013
Last Update Date	:	01/24/2017

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