MEDICARE: JULIE MCCOY GREENFIELD 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	03-02-13768	OH

General Provider Information

NPI Number	:	1922323401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MCCOY GREENFIELD R.PH.

Provider Business Mailing Address
First Line	:	1160 NORTHWOOD CIR
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9056
Country	:	US
Telephone Number	:	614-231-8877
Fax Number	:	614-231-8865

Provider Business Practice Location Address
First Line	:	4040 E BROAD ST
Second Line	:	STE 105
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1156
Country	:	US
Telephone Number	:	614-231-8877
Fax Number	:	614-231-8865

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

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	03/29/2010

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