Provider Demographics
NPI:1912470659
Name:TAO, ALLAN WEI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:WEI
Last Name:TAO
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 1:324 CASSIDY AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2503
Mailing Address - Country:US
Mailing Address - Phone:859-559-5885
Mailing Address - Fax:
Practice Address - Street 1:1502 OXFORD DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8094
Practice Address - Country:US
Practice Address - Phone:502-863-3784
Practice Address - Fax:502-863-3789
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist