Provider Demographics
NPI:1578616165
Name:HEALY, BETH RATLIFF (PHARMD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:RATLIFF
Last Name:HEALY
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 1:36 KLAINECREST AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1930
Mailing Address - Country:US
Mailing Address - Phone:859-781-9052
Mailing Address - Fax:
Practice Address - Street 1:272 PIKE ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2343
Practice Address - Country:US
Practice Address - Phone:859-261-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist