Provider Demographics
NPI:1265847115
Name:COFFEY, ASHTON R (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ASHTON
Middle Name:R
Last Name:COFFEY
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 1:254 FAIRVIEW CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-9437
Mailing Address - Country:US
Mailing Address - Phone:270-566-1511
Mailing Address - Fax:
Practice Address - Street 1:978 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-1500
Practice Address - Country:US
Practice Address - Phone:606-348-8474
Practice Address - Fax:606-348-6609
Is Sole Proprietor?:No
Enumeration Date:2014-06-29
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist