Provider Demographics
NPI:1497077200
Name:LARAMIE, DOUGLAS ALEXANDER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ALEXANDER
Last Name:LARAMIE
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 1:1331 CLAY STREET
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420
Mailing Address - Country:US
Mailing Address - Phone:270-577-2534
Mailing Address - Fax:270-827-4934
Practice Address - Street 1:1331 CLAY ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4203
Practice Address - Country:US
Practice Address - Phone:270-577-2534
Practice Address - Fax:270-827-4934
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008028089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist