| NPI | 1033815683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY BENTLEY BROWN Owner 502-265-8904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-21 |