Provider Demographics
NPI:1508148719
Name:SENAMOONTRY, ORADY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ORADY
Middle Name:
Last Name:SENAMOONTRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2682
Mailing Address - Country:US
Mailing Address - Phone:270-737-3713
Mailing Address - Fax:
Practice Address - Street 1:1602 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2682
Practice Address - Country:US
Practice Address - Phone:270-737-3713
Practice Address - Fax:270-737-7878
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist