Provider Demographics
NPI:1053296939
Name:RATLIFF, AUSTIN SHANE
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:SHANE
Last Name:RATLIFF
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 1:351 RIVER HILL DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7397
Mailing Address - Country:US
Mailing Address - Phone:606-329-0477
Mailing Address - Fax:606-326-0352
Practice Address - Street 1:351 RIVER HILL DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7397
Practice Address - Country:US
Practice Address - Phone:606-329-0477
Practice Address - Fax:606-326-0352
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY025305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist