MEDICARE: MR. ROBERT STEPHEN KAYDEN JR. R.PH.

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	RP030099L	PA

General Provider Information

NPI Number	:	1649251141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT STEPHEN KAYDEN JR. R.PH.

Provider Business Mailing Address
First Line	:	1109 LETORT RD
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9311
Country	:	US
Telephone Number	:	717-872-9267
Fax Number	:	717-581-4435

Provider Business Practice Location Address
First Line	:	1109 LETORT RD
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9311
Country	:	US
Telephone Number	:	717-872-9267
Fax Number	:	717-581-4435

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/08/2007

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