Provider Demographics
NPI:1427402882
Name:PARSONS, KENNETH (R PH)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:PARSONS
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1072
Mailing Address - Country:US
Mailing Address - Phone:502-290-2828
Mailing Address - Fax:502-290-2974
Practice Address - Street 1:834 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1072
Practice Address - Country:US
Practice Address - Phone:502-290-2828
Practice Address - Fax:502-290-2974
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY009387OtherPHARMACIST'S LICENSE