MEDICARE: MR. DALE MEYER

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	03120503	OH

General Provider Information

NPI Number	:	1558960732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DALE MEYER

Provider Business Mailing Address
First Line	:	3939 JOHN WAYNE DR
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45011-0804
Country	:	US
Telephone Number	:	513-525-3444
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 TRI COUNTY PKWY
Second Line	:
City	:	SPRINGDALE
State	:	OH
Zip	:	45246-3289
Country	:	US
Telephone Number	:	513-782-8405
Fax Number	:

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

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	10/20/2020

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Directions to “ MR. DALE MEYER ” Practice Location

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