MEDICARE: KILEY GRAFTON

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	RP442059	PA

General Provider Information

NPI Number	:	1861772469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KILEY GRAFTON

Provider Business Mailing Address
First Line	:	600 ADAMS SHOPPES
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-3966
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 ADAMS SHOPPES
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-3966
Country	:	US
Telephone Number	:	724-742-1701
Fax Number	:

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

Provider Enumeration Date	:	08/26/2011
Last Update Date	:	08/26/2011

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Directions to “ KILEY GRAFTON ” Practice Location

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