| NPI | 1386646974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY FORCHT Owner 606-528-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY P06791) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: KY P06791) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2014-05-24 |