MEDICARE: TRUDY MCNEIL

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	021345150	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3671042	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1750508834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUDY MCNEIL

Provider Business Mailing Address
First Line	:	8080 RAVINES EDGE CT
Second Line	:	STE 200
City	:	COLUMBUS
State	:	OH
Zip	:	43235
Country	:	US
Telephone Number	:	614-430-8022
Fax Number	:	614-430-8025

Provider Business Practice Location Address
First Line	:	500 EAST MAIN STREET
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-5369
Country	:	US
Telephone Number	:	614-621-8227
Fax Number	:	614-228-3481

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. SUSHIL BHAGAT
Credential	:	RPH
Telephone Number	:	614-621-8227

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	10/20/2008

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Directions to “TRUDY MCNEIL ” Practice Location

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