| NPI | 1306878988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS K. HUDNALL President 270-651-5159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY poo704) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: KY p00704) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 012590) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-04-17 |