Individual
MARIA MARGARET GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 PATROL RD, CHARLESTOWN, IN 47111-8670
(513) 378-9081
Mailing address
2144 LAKESIDE DR, LOUISVILLE, KY 40205-2544
(513) 378-9081
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027558A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019661
REGISTERED PHARMACIST
KY
01
—
26027558A
REGISTERED PHARMACIST
IN
Enumeration date
09/05/2019
Last updated
09/05/2019
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