| NPI | 1174955967 |
|---|---|
| Doing Business As | KENTUCKYCARE PHARMACY 62 |
| Entity Type | Organization |
| Authorized Contact | STEVEN COLLIER CEO 870-347-2534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P07590) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07590) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2021-01-14 |