Provider Demographics
NPI:1235671256
Name:CHANG, JULIE C (RPH)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:CHANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 GINGERMILL LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1922
Mailing Address - Country:US
Mailing Address - Phone:859-227-7137
Mailing Address - Fax:859-543-8525
Practice Address - Street 1:740 SOUTH LIMESTONE
Practice Address - Street 2:J134
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-257-8769
Practice Address - Fax:859-323-1056
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012483183500000X
VA0202204675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist