| NPI | 1013648195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN LYSINGER VP 502-580-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-06-12 |