Doctor Name: | TABATHA M ENGALND |
NPI Number: | 1790125375 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT00013046 |
Business Practice Address: | 612 W Stockton St Edmonton, KY - 421299458 |
Business Phone Number: | 2704323865 |
Business Fax Number: | 2704327750 |
Mailing Address: | 1825 Echo Rd, KNOB LICK |
State: | KY |
Postal Code: | 421548341 |
Phone Number: | 2704327574 |
Fax Number: | 2704327750 |
NPI Enumeration Date: | 06/27/2013 |
NPI Last Update Date: | 06/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | PT00013046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |