| NPI | 1043397912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GOBLE President 502-895-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P02419) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |