Provider Demographics
NPI:1407450166
Name:GERALDS, DONNY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DONNY
Middle Name:
Last Name:GERALDS
Suffix:
Gender:M
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 1:3097 TODDS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1276
Mailing Address - Country:US
Mailing Address - Phone:859-266-3202
Mailing Address - Fax:859-266-0382
Practice Address - Street 1:3097 TODDS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1276
Practice Address - Country:US
Practice Address - Phone:859-266-3202
Practice Address - Fax:859-266-0382
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0140471835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY014047OtherPHARMACIST LICENSE NUMBER