MEDICARE: KAREN C MAHANEY PHARM D

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	9986	KY

General Provider Information

NPI Number	:	1427214394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN C MAHANEY PHARM D

Provider Business Mailing Address
First Line	:	244 ELLERSLIE PARK BLVD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-5716
Country	:	US
Telephone Number	:	859-309-2656
Fax Number	:	859-309-2656

Provider Business Practice Location Address
First Line	:	3813 DYLAN PL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40514-1062
Country	:	US
Telephone Number	:	859-219-0102
Fax Number	:	859-219-0341

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

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	07/31/2008

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