Provider Demographics
NPI:1376029025
Name:PRATHER, ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PRATHER
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 1:1 PINE RDG
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1556
Mailing Address - Country:US
Mailing Address - Phone:859-630-8274
Mailing Address - Fax:
Practice Address - Street 1:7220 BURLINGTON PIKE STE I
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1586
Practice Address - Country:US
Practice Address - Phone:859-746-2800
Practice Address - Fax:859-746-2802
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist