Healthcare Provider Details

I. General information

NPI: 1669500906
Provider Name (Legal Business Name): LINDA SUE GORMLEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2446 ANDERSON RD
CRESCENT SPRINGS KY
41017-1400
US

IV. Provider business mailing address

1017 APPLEBLOSSOM DR
VILLA HILLS KY
41017-5348
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-1660
  • Fax: 859-344-4142
Mailing address:
  • Phone: 859-331-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7463
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: