Provider Demographics
NPI:1487139291
Name:PARMLEY, GORDON ELVIS (PHARMD)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:ELVIS
Last Name:PARMLEY
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 1:198 DOCKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-5499
Mailing Address - Country:US
Mailing Address - Phone:606-875-6812
Mailing Address - Fax:
Practice Address - Street 1:198 DOCKVIEW RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-5499
Practice Address - Country:US
Practice Address - Phone:606-340-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03224966-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist