Provider Demographics
NPI:1952932386
Name:MINOR, ALLISON M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:MINOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 GRANDEL BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3097
Mailing Address - Country:US
Mailing Address - Phone:502-727-5575
Mailing Address - Fax:
Practice Address - Street 1:4915 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2501
Practice Address - Country:US
Practice Address - Phone:502-448-8247
Practice Address - Fax:502-448-8283
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028497A1835P0018X
KY0137111835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist