Healthcare Provider Details

I. General information

NPI: 1578223079
Provider Name (Legal Business Name): TONI DARLENE FICK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 OUTER LOOP
LOUISVILLE KY
40214-5544
US

IV. Provider business mailing address

4042 PEACHTREE AVE
LOUISVILLE KY
40215-2560
US

V. Phone/Fax

Practice location:
  • Phone: 502-361-8299
  • Fax: 502-361-8978
Mailing address:
  • Phone: 502-593-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number022515
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: