Provider Demographics
NPI:1598048548
Name:GOEING, RAYMOND DOUGLAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:DOUGLAS
Last Name:GOEING
Suffix:
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 1:3980 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4144
Mailing Address - Country:US
Mailing Address - Phone:502-447-4232
Mailing Address - Fax:502-447-5796
Practice Address - Street 1:3980 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4144
Practice Address - Country:US
Practice Address - Phone:502-447-4232
Practice Address - Fax:502-447-5796
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist