Healthcare Provider Details

I. General information

NPI: 1073152575
Provider Name (Legal Business Name): ASHLAND TODD PRICE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2019
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 N 12TH ST
MURRAY KY
42071-1666
US

IV. Provider business mailing address

263 APOSTLE PAUL LOOP
CADIZ KY
42211-8836
US

V. Phone/Fax

Practice location:
  • Phone: 270-759-1288
  • Fax: 270-759-1310
Mailing address:
  • Phone: 270-350-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11210
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: