Provider Demographics
NPI:1831865849
Name:HARDY, GABRIEL SCOTT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:SCOTT
Last Name:HARDY
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 1:3917 S GRIFFITH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6855
Mailing Address - Country:US
Mailing Address - Phone:270-302-4863
Mailing Address - Fax:
Practice Address - Street 1:3030 BURLEW BLVD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-6486
Practice Address - Country:US
Practice Address - Phone:270-685-4931
Practice Address - Fax:270-685-5742
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist