MEDICARE: MR. JAMES M CONWAY 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	03-1-17470	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03-1-17470	OTHER	OH	PHARMACY LISC

General Provider Information

NPI Number	:	1770646887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES M CONWAY R.PH.

Provider Business Mailing Address
First Line	:	4365 CARNATION CIR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4905
Country	:	US
Telephone Number	:	513-244-6629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 WILLIAM HOWARD TAFT RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1721
Country	:	US
Telephone Number	:	513-872-8700
Fax Number	:

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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