| NPI | 1356514632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SMITH Vice President 606-549-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: KY P07247) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2016-01-07 |