MEDICARE: KIRBY KASETA

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	019420	KY
2	183500000X	Pharmacist	26027275A	IN

General Provider Information

NPI Number	:	1417560152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRBY KASETA

Provider Business Mailing Address
First Line	:	934 SPRING ST # 940
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3639
Country	:	US
Telephone Number	:	812-283-1389
Fax Number	:

Provider Business Practice Location Address
First Line	:	934 SPRING ST # 940
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3639
Country	:	US
Telephone Number	:	812-283-1389
Fax Number	:

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

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	08/24/2020

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Directions to “ KIRBY KASETA ” Practice Location

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