Provider Demographics
NPI:1639722549
Name:GADDIS, BRITTANY (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GADDIS
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 1:186 HAWK LNDG
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-4938
Mailing Address - Country:US
Mailing Address - Phone:270-403-7557
Mailing Address - Fax:
Practice Address - Street 1:1608 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9662
Practice Address - Country:US
Practice Address - Phone:270-789-4734
Practice Address - Fax:270-789-3694
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist