MEDICARE: SETH MCCORMICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	015033	KY

General Provider Information

NPI Number	:	1487254116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH MCCORMICK

Provider Business Mailing Address
First Line	:	1195 BARRETT BLVD
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-7508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1195 BARRETT BLVD
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-7508
Country	:	US
Telephone Number	:	270-826-6926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2020
Last Update Date	:	10/30/2020

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Directions to “ SETH MCCORMICK ” Practice Location

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