Provider Demographics
NPI:1932499555
Name:KINGREY, ERIN R (PHARM D)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:KINGREY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 AUSTIN TRACY RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:KY
Mailing Address - Zip Code:42123-9708
Mailing Address - Country:US
Mailing Address - Phone:270-434-3468
Mailing Address - Fax:
Practice Address - Street 1:704 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1544
Practice Address - Country:US
Practice Address - Phone:270-629-6337
Practice Address - Fax:270-629-3784
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist