MEDICARE: VINCENT PICKENS CPHT

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	183700000X	Pharmacy Technician

General Provider Information

NPI Number	:	1528671518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT PICKENS CPHT

Provider Business Mailing Address
First Line	:	6901 MIAMI AVE
Second Line	:
City	:	MADEIRA
State	:	OH
Zip	:	45243-2632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 MIAMI AVE
Second Line	:
City	:	MADEIRA
State	:	OH
Zip	:	45243-2632
Country	:	US
Telephone Number	:	513-272-3409
Fax Number	:

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

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	08/28/2020

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Directions to “ VINCENT PICKENS CPHT” Practice Location

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