MEDICARE: MRS. JOLENE ANN BILBEE-OSBACK

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	3712	WY

General Provider Information

NPI Number	:	1134309313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOLENE ANN BILBEE-OSBACK

Provider Business Mailing Address
First Line	:	1801 E PARK AVE
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-4803
Country	:	US
Telephone Number	:	307-851-9119
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 GREAT PLAINS RD
Second Line	:
City	:	ARAPAHOE
State	:	WY
Zip	:	82501
Country	:	US
Telephone Number	:	307-856-9281
Fax Number	:

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

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/06/2007

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