Provider Demographics
NPI:1063572592
Name:HARDY, KATHY RENEE (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:RENEE
Last Name:HARDY
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:SMITHS GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:42171
Mailing Address - Country:US
Mailing Address - Phone:270-843-6785
Mailing Address - Fax:
Practice Address - Street 1:3158 LOUISVILLE ROAD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-7102
Practice Address - Country:US
Practice Address - Phone:270-842-6161
Practice Address - Fax:270-782-7466
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist