| NPI | 1073032074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD STEPHENS Authorized Official 606-526-9006 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: KY P07856) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2024-06-28 |