MEDICARE: MICHAEL MAYROSH PHARMD, 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	RP449745	PA

General Provider Information

NPI Number	:	1467815977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MAYROSH PHARMD, RPH

Provider Business Mailing Address
First Line	:	2010 BROOKS EDGE DR
Second Line	:	APT 201
City	:	CAMP HILL
State	:	PA
Zip	:	17011-8038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5050 JONESTOWN RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2921
Country	:	US
Telephone Number	:	717-652-9190
Fax Number	:

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

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	04/01/2016

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