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NPI Code Detail

MEDICARE: JANIS L GOLLER RPH

MEDICARE: JANIS L GOLLER 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
1183500000XPharmacist011067KY
2183500000XPharmacist03-2-21500OH

General Provider Information

NPI Number : 1699056184
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANIS L GOLLER RPH
Provider Business Mailing Address
First Line : 1 VIEWPOINT DR
Second Line :
City : ALEXANDRIA
State : KY
Zip : 41001-1086
Country : US
Telephone Number : 859-635-1420
Fax Number : 859-635-1473
Provider Business Practice Location Address
First Line : 1 VIEWPOINT DR
Second Line :
City : ALEXANDRIA
State : KY
Zip : 41001-1086
Country : US
Telephone Number : 859-635-1420
Fax Number : 859-635-1473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2011
Last Update Date : 08/29/2011

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