Healthcare Provider Details

I. General information

NPI: 1720295371
Provider Name (Legal Business Name): MULLANEY MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 12/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7846 CINCINNATI DAYTON RD
WEST CHESTER OH
45069-2009
US

IV. Provider business mailing address

7846 CINCINNATI DAYTON RD
WEST CHESTER OH
45069-2009
US

V. Phone/Fax

Practice location:
  • Phone: 513-779-9808
  • Fax: 513-587-7645
Mailing address:
  • Phone: 513-779-9808
  • Fax: 513-587-7645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRTP02223310003
License Number StateOH

VIII. Authorized Official

Name: THOMAS MULLANEY
Title or Position: PRESIDENT
Credential:
Phone: 513-587-6201