Provider Demographics
NPI:1669506127
Name:MINOGUE, JUDITH ZAX (RPH)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ZAX
Last Name:MINOGUE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9317 REAMERS RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-6013
Mailing Address - Country:US
Mailing Address - Phone:502-550-4151
Mailing Address - Fax:
Practice Address - Street 1:4014 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4715
Practice Address - Country:US
Practice Address - Phone:502-894-4464
Practice Address - Fax:502-893-4460
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist