Mariah Lavere
Individual provider Active NPI Pharmacist · Hodgenville, KY
NPI 1174073191 · NPPES record last updated Oct 13, 2016
Key facts
- NPI
- 1174073191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 018880 (KY)
- Practice address
- 415 N Lincoln Blvd
Hodgenville, KY 42748-1610 - Phone
- (270) 358-3186
- NPI assigned
- Oct 13, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018880 | KY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018880 | KY | Yes |
Addresses
Primary practice location
415 N Lincoln Blvd
Hodgenville, KY 42748-1610
Mailing address
415 N Lincoln Blvd
Hodgenville, KY 42748-1610
Other providers in Hodgenville, KY
- Brittain Cole Jackson
- Shauna Kristen Johnson
- Larue County Board of Education
- Larue County County Treasurer
- Larue County Geriatric Center, Inc.
- Lincoln Trail District Health Department
- Lincoln Way LLC Janice Diane Haycraft Single MBR
- Louisville Optometric Centers, III PSC
- Louisville Optometric Centers, III PSC
- LP Hodgenville LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.