Provider Demographics
NPI:1699844811
Name:EATMON, COURTNEY VINCENT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:VINCENT
Last Name:EATMON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:LEIGH
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:908 KILLEAN CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8664
Mailing Address - Country:US
Mailing Address - Phone:859-321-3632
Mailing Address - Fax:
Practice Address - Street 1:1101 VETERANS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2235
Practice Address - Country:US
Practice Address - Phone:859-233-4511
Practice Address - Fax:859-281-4851
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012972183500000X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric