MEDICARE: MICHELLE HABASHY

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	1-14785	KS

General Provider Information

NPI Number	:	1376851824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE HABASHY

Provider Business Mailing Address
First Line	:	2572 GREENLEAF CT
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-1506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4817 E DOUGLAS AVE STE 300
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-1019
Country	:	US
Telephone Number	:	316-684-0118
Fax Number	:	316-684-3640

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

Provider Enumeration Date	:	09/17/2010
Last Update Date	:	09/17/2010

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Directions to “ MICHELLE HABASHY ” Practice Location

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