Healthcare Provider Details

I. General information

NPI: 1346387651
Provider Name (Legal Business Name): JILL R RHODES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 S JACKSON ST
LOUISVILLE KY
40202-1675
US

IV. Provider business mailing address

13512 OLIVER STATION CT
LOUISVILLE KY
40245-2128
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-7428
  • Fax: 502-561-7385
Mailing address:
  • Phone: 502-561-7428
  • Fax: 502-561-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number012742
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: