Provider Demographics
NPI:1003905100
Name:SWEENEY, EVAN M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-1205
Mailing Address - Country:US
Mailing Address - Phone:270-754-4300
Mailing Address - Fax:270-754-9881
Practice Address - Street 1:203 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-1205
Practice Address - Country:US
Practice Address - Phone:270-754-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist