Provider Demographics
NPI:1477285716
Name:MCCOMAS, BILLY JOE JR (RPH)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:JOE
Last Name:MCCOMAS
Suffix:JR
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 1:1237 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7514
Mailing Address - Country:US
Mailing Address - Phone:606-393-5588
Mailing Address - Fax:606-393-3947
Practice Address - Street 1:1237 CARTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7514
Practice Address - Country:US
Practice Address - Phone:606-393-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist