| NPI | 1386078491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY V CHOU Owner 270-433-5806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: KY 00193) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |