| NPI | 1184171704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A LARIVIERE Chief Compliance Officer 502-627-7404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WA PHAR.CF.6067076) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2019-05-24 |