MEDICARE: MARY BURNS

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	03132292-1	OH

General Provider Information

NPI Number	:	1194117150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BURNS

Provider Business Mailing Address
First Line	:	4631 WHISPERING OAK TRL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-6076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3609 WARSAW AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-1721
Country	:	US
Telephone Number	:	513-967-1720
Fax Number	:

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

Provider Enumeration Date	:	02/28/2015
Last Update Date	:	02/28/2015

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Directions to “ MARY BURNS ” Practice Location

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