MEDICARE: MULLANEY MEDICAL INC

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	3336L0003X	Long Term Care Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy
4	333600000X	Pharmacy	RTP02223310003	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3680495	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720295371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULLANEY MEDICAL INC

Provider Business Mailing Address
First Line	:	7846 CINCINNATI DAYTON RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-2009
Country	:	US
Telephone Number	:	513-779-9808
Fax Number	:	513-587-7645

Provider Business Practice Location Address
First Line	:	7846 CINCINNATI DAYTON RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-2009
Country	:	US
Telephone Number	:	513-779-9808
Fax Number	:	513-587-7645

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS MULLANEY
Credential	:
Telephone Number	:	513-587-6201

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	12/26/2012

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Directions to “MULLANEY MEDICAL INC ” Practice Location

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