MEDICARE: KAITLYN ELIZABETH SAUNDERS 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
1	183500000X	Pharmacist	03237103	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03237103	OTHER	OH	BOARD OF PHARMACY LICENSE

General Provider Information

NPI Number	:	1780226878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN ELIZABETH SAUNDERS RPH.

Provider Business Mailing Address
First Line	:	1589 COWAN CREEK DR
Second Line	:
City	:	MARYSVILLE
State	:	OH
Zip	:	43040-2562
Country	:	US
Telephone Number	:	937-441-7998
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 E PALMER RD
Second Line	:
City	:	BELLEFONTAINE
State	:	OH
Zip	:	43311-2298
Country	:	US
Telephone Number	:	937-651-6780
Fax Number	:	937-651-6781

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

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	10/10/2019

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