Healthcare Provider Details

I. General information

NPI: 1033045828
Provider Name (Legal Business Name): ASHLEY LUSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LEXINGTON AVE
ASHLAND KY
41101-2843
US

IV. Provider business mailing address

2309 10TH AVE
HUNTINGTON WV
25703-2043
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-1225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number023554
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: