Provider Demographics
NPI:1417116203
Name:WEATHERS, HARRY (RPH)
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:
Last Name:WEATHERS
Suffix:
Gender:M
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:PO BOX 4022
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-4022
Mailing Address - Country:US
Mailing Address - Phone:270-886-4466
Mailing Address - Fax:270-886-8915
Practice Address - Street 1:1112 W 7TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1818
Practice Address - Country:US
Practice Address - Phone:270-886-4466
Practice Address - Fax:270-886-8915
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist