MEDICARE: DR. JEANNE M CHEN PHARMD

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	1835P1200X	Pharmacotherapy Pharmacist	26015542A	IN

General Provider Information

NPI Number	:	1093848707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANNE M CHEN PHARMD

Provider Business Mailing Address
First Line	:	4910 KILKENNY CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-9702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 UNIVERSITY BLVD # 1451
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-274-3570
Fax Number	:	317-278-1044

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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