Provider Demographics
NPI:1083994784
Name:AUGUSTUS, CHRIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:AUGUSTUS
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 1:178 US HWY 51N
Mailing Address - Street 2:
Mailing Address - City:BARDWELL
Mailing Address - State:KY
Mailing Address - Zip Code:42023
Mailing Address - Country:US
Mailing Address - Phone:270-628-5445
Mailing Address - Fax:270-628-3179
Practice Address - Street 1:178 US HWY 51N
Practice Address - Street 2:
Practice Address - City:BARDWELL
Practice Address - State:KY
Practice Address - Zip Code:42023
Practice Address - Country:US
Practice Address - Phone:270-628-5445
Practice Address - Fax:270-628-3179
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294281183500000X
KY015076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist