MEDICARE: MR. DAVID MICHAEL FORD 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	03-1-20619	OH

General Provider Information

NPI Number	:	1467441568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID MICHAEL FORD RPH

Provider Business Mailing Address
First Line	:	2095 HIDY RD NW
Second Line	:
City	:	JEFFERSONVILLE
State	:	OH
Zip	:	43128-9710
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 COLUMBUS AVE
Second Line	:
City	:	WASHINGTON COURT HOUSE
State	:	OH
Zip	:	43160-1653
Country	:	US
Telephone Number	:	740-335-9900
Fax Number	:	740-335-6390

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/08/2007

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