Provider Demographics
NPI:1871105379
Name:GARRETT, ANDREW RYAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RYAN
Last Name:GARRETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:KY
Mailing Address - Zip Code:41008-9513
Mailing Address - Country:US
Mailing Address - Phone:502-732-4392
Mailing Address - Fax:
Practice Address - Street 1:204 PARK AVE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-9513
Practice Address - Country:US
Practice Address - Phone:502-732-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist