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General NPI Number Information
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NPI Number | 1396743894
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Entity Type | Organization
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Legal Business Name | SAINT JOSEPH BEREA HOSPITAL OUTPATIENT PHARMACY
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 305 ESTILL ST
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City | BEREA
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State | KY
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Zip | 40403-1742
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Country | US
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Telephone | 859-986-6541
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Fax | 859-986-2697
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Provider Business Mailing Address
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Address Line | 305 ESTILL ST
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City | BEREA
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State | KY
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Zip | 40403-1742
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Country | US
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Telephone | 859-986-6541
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Fax | 859-986-2697
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. JOANNE D. O'KANE
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Credential | PHARMD
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Telephone | 859-986-6541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 09724
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License Number State | KY
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