Provider Demographics
NPI:1477100246
Name:RATLIFF, DANNY R (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:R
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13598 GRAPEVINE RD
Mailing Address - Street 2:
Mailing Address - City:PHYLLIS
Mailing Address - State:KY
Mailing Address - Zip Code:41554-8406
Mailing Address - Country:US
Mailing Address - Phone:606-422-2322
Mailing Address - Fax:
Practice Address - Street 1:13598 GRAPEVINE RD
Practice Address - Street 2:
Practice Address - City:PHYLLIS
Practice Address - State:KY
Practice Address - Zip Code:41554-8406
Practice Address - Country:US
Practice Address - Phone:606-422-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist