MEDICARE: DR. HEATHER R JOHNSON PHARMD

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	014965	KY

General Provider Information

NPI Number	:	1962840835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER R JOHNSON PHARMD

Provider Business Mailing Address
First Line	:	201 S MAIN ST
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1507
Country	:	US
Telephone Number	:	270-338-4241
Fax Number	:	270-338-5558

Provider Business Practice Location Address
First Line	:	201 S MAIN ST
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1507
Country	:	US
Telephone Number	:	270-338-4241
Fax Number	:	270-338-5558

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

Provider Enumeration Date	:	06/12/2013
Last Update Date	:	06/12/2013

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Directions to “ DR. HEATHER R JOHNSON PHARMD” Practice Location

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