MEDICARE: BRENDAN J DORAN 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	0333098	OH

General Provider Information

NPI Number	:	1346686755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDAN J DORAN PHARMD

Provider Business Mailing Address
First Line	:	2323 BEDFORD AVE
Second Line	:	APT 17
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2670
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 BEDFORD AVE
Second Line	:	APT 17
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2670
Country	:	US
Telephone Number	:	513-315-4617
Fax Number	:

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

Provider Enumeration Date	:	05/13/2013
Last Update Date	:	05/13/2013

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