MEDICARE: JANICE BEVERLY MARCINIAK R.PH.

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	03-2--16488	OH

General Provider Information

NPI Number	:	1265512461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE BEVERLY MARCINIAK R.PH.

Provider Business Mailing Address
First Line	:	7142 ELGIN DR SW
Second Line	:
City	:	SHERRODSVILLE
State	:	OH
Zip	:	44675-9720
Country	:	US
Telephone Number	:	330-401-5940
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 W HIGH AVE
Second Line	:
City	:	NEW PHILADELPHIA
State	:	OH
Zip	:	44663-2005
Country	:	US
Telephone Number	:	303-394-4663
Fax Number	:	303-399-0073

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	02/02/2021

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