Healthcare Provider Details

I. General information

NPI: 1982947487
Provider Name (Legal Business Name): MARY E SWEENEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 ROLLINGWOOD CT
FLORENCE KY
41042-9114
US

IV. Provider business mailing address

1975 ROLLINGWOOD CT
FLORENCE KY
41042-9114
US

V. Phone/Fax

Practice location:
  • Phone: 859-817-1160
  • Fax:
Mailing address:
  • Phone: 859-817-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number03230317-2
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: