| NPI | 1285272575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DANIEL MILLER CEO 502-562-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |