| NPI | 1003213927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DOUGLAS Managing Owner 859-273-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: KY P06814) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |