| NPI | 1194942292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BORDES Pres 606-549-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: KY P01565) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2016-01-05 |