Provider Demographics
NPI:1225488745
Name:DERMATRAN HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:DERMATRAN HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:T
Authorized Official - Last Name:TOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:502-254-1024
Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5133
Mailing Address - Country:US
Mailing Address - Phone:502-254-1024
Mailing Address - Fax:502-470-1918
Practice Address - Street 1:2700 STANLEY GAULT PKWY STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5133
Practice Address - Country:US
Practice Address - Phone:502-254-1024
Practice Address - Fax:502-470-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0083453336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy