MEDICARE: MICHAEL PLEIMAN JR. PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03328929	OH
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	014237	KY

General Provider Information

NPI Number	:	1548554538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PLEIMAN JR. PHARMD

Provider Business Mailing Address
First Line	:	4777 KENARD AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45232-1992
Country	:	US
Telephone Number	:	513-681-7455
Fax Number	:	513-681-7931

Provider Business Practice Location Address
First Line	:	4777 KENARD AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45232-1992
Country	:	US
Telephone Number	:	513-681-7455
Fax Number	:	513-681-7931

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

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	06/07/2011

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