| NPI | 1295311058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJITH NAIR Medical Director 502-995-4004 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-12-01 |