Provider Demographics
NPI:1154840924
Name:HILL, TASHENA ELIZABETH (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:TASHENA
Middle Name:ELIZABETH
Last Name:HILL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 366
Mailing Address - Street 2:520 WEST GUM ST.
Mailing Address - City:MARION
Mailing Address - State:KY
Mailing Address - Zip Code:42064
Mailing Address - Country:US
Mailing Address - Phone:270-965-4101
Mailing Address - Fax:270-965-9957
Practice Address - Street 1:520 WEST GUM ST.
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KY
Practice Address - Zip Code:42064
Practice Address - Country:US
Practice Address - Phone:270-965-4101
Practice Address - Fax:270-965-9957
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18D2159791OtherCLIA WAIVER
KY18D2159792OtherCLIA WAIVER