| NPI | 1366819476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIGNA PATEL Agent 270-688-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY p07713) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY mg0903) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: KY mg0903) | |
| 333600000X Pharmacy (Licence: KY p07713) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2019-04-25 |