Healthcare Provider Details

I. General information

NPI: 1598750150
Provider Name (Legal Business Name): ANGELA ELIZABETH DEMOSS RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 INDIAN MOUND DR
MOUNT STERLING KY
40353-1156
US

IV. Provider business mailing address

50 EAGLE DR
MOREHEAD KY
40351-8469
US

V. Phone/Fax

Practice location:
  • Phone: 859-497-9696
  • Fax: 859-497-9495
Mailing address:
  • Phone: 606-776-6334
  • Fax: 859-497-9495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10529
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: