MEDICARE: DR. JESSICA WOODS 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	183500000X	Pharmacist	03233113	OH
2	183500000X	Pharmacist	016759	KY

General Provider Information

NPI Number	:	1225468820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA WOODS PHARMD

Provider Business Mailing Address
First Line	:	4880 HUNT RD
Second Line	:	#101
City	:	BLUE ASH
State	:	OH
Zip	:	45242-6938
Country	:	US
Telephone Number	:	859-608-5377
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 MIAMI AVE
Second Line	:
City	:	MADEIRA
State	:	OH
Zip	:	45243-2632
Country	:	US
Telephone Number	:	513-272-3409
Fax Number	:

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

Provider Enumeration Date	:	11/18/2013
Last Update Date	:	11/18/2013

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