=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598013369
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RYAN MURPHY PHARM.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2012
-----------------------------------------------------
Last Update Date | 04/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 634 N BARDSTOWN RD BOX 38
-----------------------------------------------------
City | MT WASHINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-538-8275
-----------------------------------------------------
Fax | 502-538-2729
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10914 HOBBS STATION RD
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40223-5591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-640-9271
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 016203
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------