MEDICARE: DR. STEPHANIE C SMITH COONEY PHARM. D.

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	RP439383	PA

General Provider Information

NPI Number	:	1083613087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE C SMITH COONEY PHARM. D.

Provider Business Mailing Address
First Line	:	221 PRAIRIE CT
Second Line	:
City	:	FREEPORT
State	:	PA
Zip	:	16229-2419
Country	:	US
Telephone Number	:	724-388-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 PHILADELPHIA ST
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3905
Country	:	US
Telephone Number	:	724-349-4200
Fax Number	:

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	07/08/2007

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