Provider Demographics
NPI:1871189415
Name:TROST, KHOUA
Entity Type:Individual
Prefix:
First Name:KHOUA
Middle Name:
Last Name:TROST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KHOUA
Other - Middle Name:
Other - Last Name:LOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3708 BARDSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218
Mailing Address - Country:US
Mailing Address - Phone:502-454-5975
Mailing Address - Fax:
Practice Address - Street 1:3708 BARDSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-454-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist