Healthcare Provider Details

I. General information

NPI: 1376243006
Provider Name (Legal Business Name): JONATHAN TAYLOR HUFF PHARM.D., BCCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

1024 GREENDALE RD UNIT 10206
LEXINGTON KY
40511-8342
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0295
  • Fax: 859-323-1256
Mailing address:
  • Phone: 740-981-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number022301
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: