Provider Demographics
NPI:1942922240
Name:NOBLE, RYAN CHARLES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CHARLES
Last Name:NOBLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 WENDELL FORD TERMINAL RD
Mailing Address - Street 2:
Mailing Address - City:CHAVIES
Mailing Address - State:KY
Mailing Address - Zip Code:41727-8671
Mailing Address - Country:US
Mailing Address - Phone:606-331-1397
Mailing Address - Fax:
Practice Address - Street 1:101 TOWN AND COUNTRY LN STE 100
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9524
Practice Address - Country:US
Practice Address - Phone:606-435-0460
Practice Address - Fax:606-435-0461
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY022967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist