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Individual

MR. KENNETH RAY MCCAMISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 562-3000
Mailing address
1014 PEBBLE CREEK DR, JEFFERSONVILLE, IN 47130-5792
(812) 946-0290

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
011411
KY
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26017988A
IN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PH000400009
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011411
KENTUCKY BOARD OF PHARMACY
KY
01
26017988A
INDIANA BOARD OF PHARMACY
IN
01
PH00040009
WASHINGTON STATE BOARD OF PHARMACY
WA
Enumeration date
04/11/2018
Last updated
04/11/2018
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