MEDICARE: MRS. KIMBERLEY J. MAIER 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	042340	NY

General Provider Information

NPI Number	:	1336289677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLEY J. MAIER R.PH.

Provider Business Mailing Address
First Line	:	7211 FISHER RD
Second Line	:
City	:	OAKFIELD
State	:	NY
Zip	:	14125-9433
Country	:	US
Telephone Number	:	585-948-8364
Fax Number	:

Provider Business Practice Location Address
First Line	:	6660 4TH SECTION RD
Second Line	:
City	:	BROCKPORT
State	:	NY
Zip	:	14420-2448
Country	:	US
Telephone Number	:	585-637-6855
Fax Number	:	585-637-7848

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/08/2007

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