Provider Demographics
NPI:1104952167
Name:HILL, LARRY KENNETH (RPH)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:KENNETH
Last Name:HILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:160 LINDENBERG DRIVE
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-0757
Mailing Address - Country:US
Mailing Address - Phone:606-549-0936
Mailing Address - Fax:606-526-7258
Practice Address - Street 1:108 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1422
Practice Address - Country:US
Practice Address - Phone:606-528-4380
Practice Address - Fax:606-526-7258
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY0068431835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric