MEDICARE: MRS. ADRIENNE BIRNBAUM RPH

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	03-2-21265	OH

General Provider Information

NPI Number	:	1437871696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADRIENNE BIRNBAUM RPH

Provider Business Mailing Address
First Line	:	5901 MAYFIELD RD
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-2902
Country	:	US
Telephone Number	:	440-646-1555
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 MAYFIELD RD
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-2902
Country	:	US
Telephone Number	:	440-646-1555
Fax Number	:

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

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	09/14/2022

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