MEDICARE: AMY JO HARPER

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	03221467	OH

General Provider Information

NPI Number	:	1659666469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY JO HARPER

Provider Business Mailing Address
First Line	:	124 LANSING ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-2071
Country	:	US
Telephone Number	:	615-823-0493
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-1452
Country	:	US
Telephone Number	:	614-298-1078
Fax Number	:	614-298-1078

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

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	06/09/2011

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