Provider Demographics
NPI:1134783087
Name:SADIQ, HANABLE (PHARMD)
Entity type:Individual
Prefix:
First Name:HANABLE
Middle Name:
Last Name:SADIQ
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 1:5939 BAY HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40228-1149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 INTERNATIONAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BROOKS
Practice Address - State:KY
Practice Address - Zip Code:40109-6202
Practice Address - Country:US
Practice Address - Phone:877-654-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY020101OtherKENTUCKY BOARD OF PHARMACY