Individual
FREDRICK VINCENT DA GRAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PD, R.PH., FASCP
Contact information
Practice address
3225 DARLINGTON CIR, LEXINGTON, KY 40509-2378
(859) 552-5013
Mailing address
3225 DARLINGTON CIR, LEXINGTON, KY 40509-2378
(859) 552-5013
(859) 543-0234
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000008755
TN
183500000X
Pharmacist
011753
KY
183500000X
Pharmacist
RP 0005030
WV
183500000X
Pharmacist
Primary
RPH 03216613
OH
1835N0905X
Nuclear Pharmacist
032166
OH
Other
Enumeration date
12/24/2008
Last updated
12/24/2019
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