| NPI | 1053346684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE WINDHAM Office Manager 606-877-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KY P06244) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P06244) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY PO6244) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: KY P06244) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-07-13 |