Provider Demographics
NPI:1548917115
Name:HANBALI, GADEER RASHEED (RPH)
Entity type:Individual
Prefix:DR
First Name:GADEER
Middle Name:RASHEED
Last Name:HANBALI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 BROWNHURST WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1183
Mailing Address - Country:US
Mailing Address - Phone:502-345-6700
Mailing Address - Fax:
Practice Address - Street 1:9440 BROWNSBORO RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1200
Practice Address - Country:US
Practice Address - Phone:502-425-8407
Practice Address - Fax:502-425-9793
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440370183500000X
KY021786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist