| NPI | 1013468404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN LYSINGER VP 502-580-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 16916) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2026-02-24 |