MEDICARE: MRS. CARY BETH HARTNESS 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	03222887	OH

General Provider Information

NPI Number	:	1568854883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARY BETH HARTNESS RPH

Provider Business Mailing Address
First Line	:	2120 BEECHMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-1621
Country	:	US
Telephone Number	:	513-232-4474
Fax Number	:	513-231-3965

Provider Business Practice Location Address
First Line	:	2120 BEECHMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-1621
Country	:	US
Telephone Number	:	513-232-4474
Fax Number	:	513-231-3965

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

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	02/24/2015

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