Provider Demographics
NPI:1174911770
Name:RIGNEY, ROGER TAYLOR (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:TAYLOR
Last Name:RIGNEY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:40 PUBLIC SQUARE
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-0761
Mailing Address - Country:US
Mailing Address - Phone:270-769-3246
Mailing Address - Fax:270-737-4074
Practice Address - Street 1:790 N DIXIE AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2488
Practice Address - Country:US
Practice Address - Phone:270-737-7880
Practice Address - Fax:270-737-7663
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007691183500000X
GARPH012275183500000X
FLPS 18036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist