MEDICARE: JANALEA S OLSON 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	9186	AZ

General Provider Information

NPI Number	:	1477962959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANALEA S OLSON RPH

Provider Business Mailing Address
First Line	:	2250 HWY 95
Second Line	:	SUITE 256
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442
Country	:	US
Telephone Number	:	928-763-7272
Fax Number	:	928-758-9233

Provider Business Practice Location Address
First Line	:	2250 HWAY 95
Second Line	:	SUITE 256
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-9013
Country	:	US
Telephone Number	:	928-763-7272
Fax Number	:	928-758-9233

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

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	08/08/2014

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Directions to “ JANALEA S OLSON RPH” Practice Location

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