| NPI | 1033750187 |
|---|---|
| Doing Business As | BOURBONTOWN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JUSTIN BELL President 502-370-4336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-09-30 |