Provider Demographics
NPI:1386388098
Name:PARKS, DARREN (RPH)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:PARKS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 BLANKENBAKER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2478
Mailing Address - Country:US
Mailing Address - Phone:855-647-7379
Mailing Address - Fax:
Practice Address - Street 1:2700 BLANKENBAKER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2478
Practice Address - Country:US
Practice Address - Phone:855-647-7379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029387A183500000X
FLPS63799183500000X
KY012998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist