Provider Demographics
NPI:1942386800
Name:THORNBURY, JOEL C (RPH)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:C
Last Name:THORNBURY
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 1:105 MOUNTAIN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1680
Mailing Address - Country:US
Mailing Address - Phone:606-432-6959
Mailing Address - Fax:606-433-9751
Practice Address - Street 1:1330 S MAYO TRL STE 102
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-432-2274
Practice Address - Fax:606-433-9816
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010506183500000X
VA0202010780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist