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General NPI Number Information
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NPI Number | 1043330681
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Entity Type | Individual
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Provider Name | CHAD MARION REYNOLDS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1220 N RACE ST
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City | GLASGOW
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State | KY
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Zip | 42141-3462
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Country | US
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Telephone | 270-651-7627
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Fax | 270-651-9261
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Provider Business Mailing Address
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Address Line | 202 WINDSOR AVE
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City | GLASGOW
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State | KY
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Zip | 42141-2256
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Country | US
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Telephone | 270-651-7627
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Fax | 270-651-9261
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 011224
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License Number State | KY
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