| NPI | 1215339122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN LYSINGER VP 502-580-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH28557) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2026-02-24 |