Provider Demographics
NPI:1093426587
Name:MENDEZ, MILAGROS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MILAGROS
Middle Name:
Last Name:MENDEZ
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 1:2700 BLANKENBAKER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2478
Mailing Address - Country:US
Mailing Address - Phone:855-647-7379
Mailing Address - Fax:
Practice Address - Street 1:1250 PATROL RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-8670
Practice Address - Country:US
Practice Address - Phone:855-647-7379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist