| NPI | 1184569030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARA TIPPIT Pharmacy Administrative Specialist 502-760-0089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-06-16 |