| NPI | 1093097719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY N PAGE Pharmacist 502-231-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: KY 015011) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |