MEDICARE: DR. KELSEY L JONES 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	016463	KY
2	183500000X	Pharmacist	03232787	OH

General Provider Information

NPI Number	:	1306457858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELSEY L JONES PHARMD

Provider Business Mailing Address
First Line	:	4530 EASTGATE BLVD STE 500
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1256
Country	:	US
Telephone Number	:	513-943-6340
Fax Number	:

Provider Business Practice Location Address
First Line	:	4530 EASTGATE BLVD STE 500
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1256
Country	:	US
Telephone Number	:	513-943-6340
Fax Number	:

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

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	08/10/2020

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