MEDICARE: KIMBERLY SOLOMON 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	RP041724L	PA

General Provider Information

NPI Number	:	1760818348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SOLOMON RPH

Provider Business Mailing Address
First Line	:	264 THIRD STREET
Second Line	:
City	:	EYNON
State	:	PA
Zip	:	18403
Country	:	US
Telephone Number	:	570-876-6446
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 CONSTITUTION AVE
Second Line	:
City	:	JESSUP
State	:	PA
Zip	:	18434-1218
Country	:	US
Telephone Number	:	570-383-7311
Fax Number	:	570-383-7399

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

Provider Enumeration Date	:	09/16/2013
Last Update Date	:	09/16/2013

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Directions to “ KIMBERLY SOLOMON RPH” Practice Location

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