Provider Demographics
NPI:1386054435
Name:TROST, GUNNAR
Entity type:Individual
Prefix:
First Name:GUNNAR
Middle Name:
Last Name:TROST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-4153
Mailing Address - Country:US
Mailing Address - Phone:502-326-5210
Mailing Address - Fax:502-326-5265
Practice Address - Street 1:4100 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-4153
Practice Address - Country:US
Practice Address - Phone:502-326-5210
Practice Address - Fax:502-326-5265
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016084183500000X
IN26024624A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26024624AOtherINDIANA BOARD OF PHARMACY
KY016084OtherKENTUCKY BOARD OF PHARMACY