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NPI Code Detail

MEDICARE: DR. CHRIS JOHNSON PHARMD

MEDICARE: DR. CHRIS JOHNSON 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
11835P1200XPharmacotherapy Pharmacist26026654AIN

General Provider Information

NPI Number : 1649702176
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRIS JOHNSON PHARMD
Provider Business Mailing Address
First Line : 12429 MUSCOVY DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-9161
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5909 ILLINOIS RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1159
Country : US
Telephone Number : 260-434-3910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2017
Last Update Date : 04/03/2017

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