| NPI | 1215227103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROBERT RUSSELL CEO 502-817-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TX 27630) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2025-10-21 |