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NPI Code Detail

MEDICARE: MRS. MARY BETH POLAND RPH

MEDICARE: MRS. MARY BETH POLAND 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
1183500000XPharmacist029640NY

General Provider Information

NPI Number : 1447582879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY BETH POLAND RPH
Provider Business Mailing Address
First Line : 416 5TH AVE
Second Line :
City : TROY
State : NY
Zip : 12182-3007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 416 5TH AVE
Second Line :
City : TROY
State : NY
Zip : 12182-3007
Country : US
Telephone Number : 518-235-2522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2010
Last Update Date : 02/10/2010

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Directions to “ MRS. MARY BETH POLAND RPH” Practice Location

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