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General NPI Number Information
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NPI Number | 1902352214
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Entity Type | Individual
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Provider Name | LABAN EUGENE YOUNG R.PH.
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Gender | Male
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 08/27/2016
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Provider Practice Location Address
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Address Line | 408 N LOCK AVE
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City | LOUISA
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State | KY
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Zip | 41230-1115
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Country | US
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Telephone | 606-638-4155
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Fax | 606-638-1109
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Provider Business Mailing Address
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Address Line | PO BOX 69
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City | LOUISA
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State | KY
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Zip | 41230-0069
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Country | US
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Telephone | 606-793-4113
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Fax | 606-638-1109
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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 | 008058
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License Number State | KY
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