Healthcare Provider Details

I. General information

NPI: 1376622167
Provider Name (Legal Business Name): AMMIE C HURTER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 FREDERICA STREET
OWENSBORO KY
42301
US

IV. Provider business mailing address

330 FREDERICA STREET
OWENSBORO KY
42301
US

V. Phone/Fax

Practice location:
  • Phone: 270-684-2341
  • Fax: 270-684-2396
Mailing address:
  • Phone: 270-684-2341
  • Fax: 270-684-2396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number012027
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: