Provider Demographics
NPI:1770182743
Name:ARMSTRONG, GLENN TIMOTHY (RPH)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:TIMOTHY
Last Name:ARMSTRONG
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 1:234 EASTBROOKE PKWY
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-5600
Mailing Address - Country:US
Mailing Address - Phone:502-538-1241
Mailing Address - Fax:502-538-1243
Practice Address - Street 1:234 EASTBROOKE PKWY
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-5600
Practice Address - Country:US
Practice Address - Phone:502-538-1241
Practice Address - Fax:502-538-1243
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0096341835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist