| NPI | 1417969882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON L. BROWN Secretary 502-630-7429 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: CA PHY48703) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: CA PHY44486) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-02-13 |