MEDICARE: MICHAELA PERRY PHARMD

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	022186	KY

General Provider Information

NPI Number	:	1982378410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAELA PERRY PHARMD

Provider Business Mailing Address
First Line	:	7410 STEEPLECREST CIR APT 309
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-9150
Country	:	US
Telephone Number	:	217-622-4201
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 TIMBER RIDGE DR
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-8131
Country	:	US
Telephone Number	:	502-228-3304
Fax Number	:

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

Provider Enumeration Date	:	08/07/2021
Last Update Date	:	08/07/2021

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Directions to “ MICHAELA PERRY PHARMD” Practice Location

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