Provider Demographics
NPI:1992138861
Name:WARNELL, SAMUEL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:WARNELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42210-9427
Mailing Address - Country:US
Mailing Address - Phone:270-246-1803
Mailing Address - Fax:
Practice Address - Street 1:166 LEWIS RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42210-9427
Practice Address - Country:US
Practice Address - Phone:270-246-1803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016007183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist