| NPI | 1174910186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA FALLER CEO 270-566-4429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07688) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0004X Pharmacy Compounding Pharmacy (Licence: KY P07688) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2016-01-15 |