MEDICARE: TAYLOR MESEROLE PHARMD, 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	051.301655	IL
2	183500000X	Pharmacist	19464-40	WI

General Provider Information

NPI Number	:	1821622929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR MESEROLE PHARMD, RPH

Provider Business Mailing Address
First Line	:	823 N MARION AVE
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53548-2332
Country	:	US
Telephone Number	:	815-543-8160
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 N MARION AVE
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53548-2332
Country	:	US
Telephone Number	:	815-543-8160
Fax Number	:

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

Provider Enumeration Date	:	02/27/2020
Last Update Date	:	01/28/2023

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