MEDICARE: JANE M MUELLER 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	9774	WI

General Provider Information

NPI Number	:	1659656866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE M MUELLER R.PH.

Provider Business Mailing Address
First Line	:	606 S WHITNEY WAY
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-1035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	742 ONEIDA PL
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53711-2958
Country	:	US
Telephone Number	:	608-219-3909
Fax Number	:

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

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	10/19/2011

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