| NPI | 1174967269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE DEBORD YOUNCE Chief Of Payer Administration 859-257-9521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KY P07556) |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: KY P07556) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2022-07-18 |