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General NPI Number Information
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NPI Number | 1962119818
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Entity Type | Individual
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Provider Name | JOHNATHON HURT PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 102 VILLAGE LN
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City | HAZARD
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State | KY
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Zip | 41701-9408
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Country | US
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Telephone | 606-435-2363
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Fax |
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Provider Business Mailing Address
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Address Line | 476 REED HURT RD
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City | CAMPTON
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State | KY
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Zip | 41301-8011
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Country | US
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Telephone |
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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 | 022918
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License Number State | KY
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