Healthcare Provider Details

I. General information

NPI: 1629244207
Provider Name (Legal Business Name): KELLY H MUHA PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 SLATE AVE
OWINGSVILLE KY
40360-2201
US

IV. Provider business mailing address

60 SLATE AVE
OWINGSVILLE KY
40360-2201
US

V. Phone/Fax

Practice location:
  • Phone: 606-674-6979
  • Fax: 606-674-2637
Mailing address:
  • Phone: 606-674-6979
  • Fax: 606-674-2637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number012356
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: