Provider Demographics
NPI:1871814319
Name:PITTMAN, ASHLEY J (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7483 BANDANA RD
Mailing Address - Street 2:
Mailing Address - City:KEVIL
Mailing Address - State:KY
Mailing Address - Zip Code:42053-8840
Mailing Address - Country:US
Mailing Address - Phone:270-559-5729
Mailing Address - Fax:
Practice Address - Street 1:409 COURT ST
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:KY
Practice Address - Zip Code:42087
Practice Address - Country:US
Practice Address - Phone:270-335-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist