Provider Demographics
NPI:1356560866
Name:STONE, MADELINE KEMPER
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:KEMPER
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 HATHERLEIGH LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5006
Mailing Address - Country:US
Mailing Address - Phone:502-426-9835
Mailing Address - Fax:502-239-3521
Practice Address - Street 1:8014 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3440
Practice Address - Country:US
Practice Address - Phone:502-239-1256
Practice Address - Fax:502-239-3521
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist