| NPI | 1134571722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN LYSINGER VP 502-580-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH30233) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2025-06-12 |