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NPI Code Detail

MEDICARE: JULIA CLEMENS

MEDICARE: JULIA CLEMENS
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
1183500000XPharmacist03338273OH

General Provider Information

NPI Number : 1700499605
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA CLEMENS
Provider Business Mailing Address
First Line : 105 N KENNEBEC AVE
Second Line :
City : MCCONNELSVILLE
State : OH
Zip : 43756-1254
Country : US
Telephone Number : 740-962-2552
Fax Number : 740-962-2730
Provider Business Practice Location Address
First Line : 105 N KENNEBEC AVE
Second Line :
City : MCCONNELSVILLE
State : OH
Zip : 43756-1254
Country : US
Telephone Number : 740-962-2552
Fax Number : 740-962-2730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 04/30/2024

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