| NPI | 1104385806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE WHITT COO 502-266-2530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2022-05-05 |