MEDICARE: EMILY PEACE

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	03444385	OH
2	183500000X	Pharmacist	024291	KY

General Provider Information

NPI Number	:	1023843117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY PEACE

Provider Business Mailing Address
First Line	:	14519 S FORK CHURCH RD
Second Line	:
City	:	VERONA
State	:	KY
Zip	:	41092-9219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 BEECHMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-1621
Country	:	US
Telephone Number	:	513-232-4474
Fax Number	:

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

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	09/06/2024

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Directions to “ EMILY PEACE ” Practice Location

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