MEDICARE: JOSEPH CRESAP

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	PSI31210	FL

General Provider Information

NPI Number	:	1063803864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH CRESAP

Provider Business Mailing Address
First Line	:	2117 BUTLERSBRIDGE CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-2653
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 BUTLERSBRIDGE CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-2653
Country	:	US
Telephone Number	:	513-235-2029
Fax Number	:

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

Provider Enumeration Date	:	02/15/2015
Last Update Date	:	02/15/2015

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Directions to “ JOSEPH CRESAP ” Practice Location

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