Provider Demographics
NPI:1619090032
Name:FRANKLIN, MARCUS (RPH)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:FRANKLIN
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 1:4428 SPURRIER RD
Mailing Address - Street 2:
Mailing Address - City:BIG CLIFTY
Mailing Address - State:KY
Mailing Address - Zip Code:42712-6819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:IRELAND LOOP BLDG 851
Practice Address - Street 2:PHARMACY SERVICE
Practice Address - City:FT. KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121
Practice Address - Country:US
Practice Address - Phone:502-624-9036
Practice Address - Fax:502-624-9873
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist