Provider Demographics
NPI:1073152575
Name:PRICE, ASHLAND TODD
Entity Type:Individual
Prefix:
First Name:ASHLAND
Middle Name:TODD
Last Name:PRICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 APOSTLE PAUL LOOP
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-8836
Mailing Address - Country:US
Mailing Address - Phone:270-350-2441
Mailing Address - Fax:
Practice Address - Street 1:808 N 12TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1666
Practice Address - Country:US
Practice Address - Phone:270-759-1288
Practice Address - Fax:270-759-1310
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist