Healthcare Provider Details

I. General information

NPI: 1457274441
Provider Name (Legal Business Name): CALEB MATTHEW DAMRON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 LEFT FORK PENHOOK BRANCH ROAD
HAROLD KY
41635
US

IV. Provider business mailing address

24 LEFT FORK PENHOOK BRANCH ROAD
HAROLD KY
41635
US

V. Phone/Fax

Practice location:
  • Phone: 606-285-6690
  • Fax:
Mailing address:
  • Phone: 606-285-6690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number025412
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: