Provider Demographics
NPI:1609917442
Name:POWELL, LARRY F (BSPH)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:F
Last Name:POWELL
Suffix:
Gender:M
Credentials:BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 IDYLWILD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3610
Mailing Address - Country:US
Mailing Address - Phone:859-623-5003
Mailing Address - Fax:859-623-8065
Practice Address - Street 1:793 EASTERN BY-PASS
Practice Address - Street 2:SUITE G-01
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-623-8065
Practice Address - Fax:859-623-8065
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist