| NPI | 1346375359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY LONG VP 386-698-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P06107) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY PO6107) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2009-12-17 |