Provider Demographics
NPI:1043812514
Name:QAISI, VEMIHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VEMIHAN
Middle Name:
Last Name:QAISI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2153
Mailing Address - Country:US
Mailing Address - Phone:270-360-1913
Mailing Address - Fax:
Practice Address - Street 1:1500 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7984
Practice Address - Country:US
Practice Address - Phone:270-763-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012042183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY012042OtherKENTUCKY BOARD OF PHARMACY