MEDICARE: DR. LORI MICHELLE RILEY PHARMD.

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	26019270A	IN

General Provider Information

NPI Number	:	1598073918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI MICHELLE RILEY PHARMD.

Provider Business Mailing Address
First Line	:	1310 W MORTON ST
Second Line	:
City	:	OAKLAND CITY
State	:	IN
Zip	:	47660-7615
Country	:	US
Telephone Number	:	812-749-4129
Fax Number	:	812-749-4561

Provider Business Practice Location Address
First Line	:	1310 W MORTON ST
Second Line	:
City	:	OAKLAND CITY
State	:	IN
Zip	:	47660-7615
Country	:	US
Telephone Number	:	812-749-4129
Fax Number	:	812-749-4561

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

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	09/20/2010

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