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NPI Code Detail

MEDICARE: MS. JILLIAN MARIE MARTIN RPH

MEDICARE: MS. JILLIAN MARIE MARTIN 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist03-3-25566OH
2183500000XPharmacist03-3-25566OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103-3-25566OTHEROHSTATE BOARD OF PHARMACY

General Provider Information

NPI Number : 1649558529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JILLIAN MARIE MARTIN RPH
Provider Business Mailing Address
First Line : 5830 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1623
Country : US
Telephone Number : 513-574-5044
Fax Number : 513-574-3457
Provider Business Practice Location Address
First Line : 5830 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1623
Country : US
Telephone Number : 513-574-5044
Fax Number : 513-574-3457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2011
Last Update Date : 02/19/2015

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