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General NPI Number Information
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NPI Number | 1598545451
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Entity Type | Individual
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Provider Name | HENRY WHITAKER III RPH
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Gender | Male
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 7101 CEDAR SPRINGS BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40291-2587
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Country | US
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Telephone | 502-231-6867
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Fax |
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Provider Business Mailing Address
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Address Line | 8609 BLUEBELL DR
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City | LOUISVILLE
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State | KY
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Zip | 40219-4941
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Country | US
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Telephone | 606-767-3443
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Fax |
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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 | 023851
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License Number State | KY
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