MEDICARE: MRS. LYNN A MORAN 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	03-3-13469	OH
2	183500000X	Pharmacist	RP027744L	PA

General Provider Information

NPI Number	:	1801979307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNN A MORAN RPH

Provider Business Mailing Address
First Line	:	6229 BROOKMEADE CIR
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-9085
Country	:	US
Telephone Number	:	614-371-2626
Fax Number	:	614-875-9862

Provider Business Practice Location Address
First Line	:	6229 BROOKMEADE CIR
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-9085
Country	:	US
Telephone Number	:	614-371-2626
Fax Number	:	614-875-9862

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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